PDF(Pubmed)
Abstract：
Abdominal wall reconstruction (AWR) is a surgical procedure performed to address various conditions such as hernias, incisional hernias, and complex abdominal wall defects. Mesh fixation plays a crucial role in providing mechanical reinforcement to the weakened abdominal wall during AWR. Traditionally, suturing has been the preferred method for mesh fixation; however, adhesion techniques using tissue adhesives or glues have gained attention as an alternative approach. This systematic review aims to compare suturing and adhesion techniques for mesh fixation in AWR and assess their effectiveness in preventing hernia recurrence. A comprehensive literature search was conducted across relevant databases, including PubMed, MEDLINE, Embase, and the Cochrane Library. Studies that fulfilled the predetermined eligibility criteria were included. The primary outcome measure of interest was hernia recurrence rates. Secondary outcomes included mesh-related complications, surgical site infections, patient-reported outcomes, and functional outcomes. A risk of bias assessment was performed for the included studies, and data were synthesized qualitatively. Overall, the results of the included studies suggest that atraumatic mesh fixation with glue may have the potential to reduce chronic groin pain (CGP). However, there were significant variations in patient selection criteria, glue administration techniques, and hernia repair methods among the trials, which limited the ability to draw definitive conclusions. Additionally, the definitions of CGP and measurement scales for postoperative pain varied across studies, making it challenging to compare outcomes. The limitations of the review include the small sample sizes in some trials, relatively short follow-up durations, and the lack of standardized criteria for assessing variables such as foreign body sensation and groin compliance. Furthermore, the economic implications of using glue fixation compared to traditional suture fixation need to be considered.
摘要：
腹壁重建（AWR）是一种外科手术，用于解决各种疾病，例如疝气，切口疝,和复杂的腹壁缺损。网格固定在AWR期间为弱化的腹壁提供机械增强中起着至关重要的作用。传统上,缝合一直是网片固定的首选方法；然而，作为一种替代方法，使用组织粘合剂或胶水的粘附技术已经受到关注。本系统综述旨在比较AWR网片固定的缝合和粘连技术，并评估其预防疝气复发的有效性。在相关数据库中进行了全面的文献检索，包括PubMed,MEDLINE,Embase,还有Cochrane图书馆.包括满足预定资格标准的研究。感兴趣的主要结果指标是疝复发率。次要结果包括网状相关并发症，手术部位感染,患者报告的结果，和功能结果。对纳入的研究进行了偏倚风险评估，数据进行了定性合成。总的来说,纳入研究的结果提示,用胶进行无创伤网片固定可能具有减轻慢性腹股沟疼痛(CGP)的潜力.然而,患者选择标准存在显著差异，胶水管理技术，试验中的疝修复方法，这限制了得出明确结论的能力。此外,CGP的定义和术后疼痛的测量量表在研究中各不相同，使比较结果具有挑战性。审查的局限性包括在一些试验中样本量小，随访持续时间相对较短，以及缺乏评估异物感和腹股沟顺应性等变量的标准化标准。此外，与传统缝线固定相比，使用胶水固定的经济意义需要考虑。
