TY - JOUR
T1 - Laparoscopic techniques versus open techniques for inguinal hernia repair
AU - The EU Hernia Trialists Collaboration
AU - The Steering Committee
AU - The Secretariat
AU - The Collaborators
AU - Coala Trial Steering Committee
AU - Fingerhut, Abe
AU - Go, Peter
AU - Grant, Adrian M.
AU - Kingsnorth, Andrew
AU - Merello, Jesús
AU - O’Dwyer, Paddy
AU - Payne, John
AU - McCormack, Kirsty
AU - Ross, Sue
AU - Scott, Neil
AU - Vale, Luke
AU - Aitola, Petri
AU - Anderberg, Bo
AU - Arvidsson, Dag
AU - Barkun, Jeffrey
AU - Barth Jnr, Richard
AU - Bay-Nielsen, Morten
AU - Beets, Geerard
AU - Bittner, Reinhard
AU - Bringman, Sven
AU - Callesen, Torben
AU - Castoro, Carlo
AU - Dirksen, Carmen
AU - Filipi, Charles
AU - Fitzgibbons, Robert
AU - Friis, Esbern
AU - Girão, Ricardo
AU - Graham, Paul
AU - Hatzitheoklitos, Efthimios
AU - Hauters, Philippe
AU - Heikkinen, Timo
AU - Jeekel, Hans
AU - Johansson, Bo
AU - Juul, Poul
AU - Kald, Anders
AU - Kehlet, Henrik
AU - Khoury, Najib
AU - Klingler, Anton
AU - Köninger, J.
AU - Kozol, Robert
AU - Leibl, Bernhard
AU - Macintyre, Ian
AU - Maddern, Guy
AU - McGillicuddy, James
AU - Millat, Bertrand
AU - Nilsson, Erik
AU - Nordin, Pär
AU - Paganini, Alessandro
AU - Pappalardo, Giuseppe
AU - Pedrós, Joan Sala
N1 - Funding Information:
We thank all members of the EU Hernia Trialists Collaboration for their invaluable contribution. The Steering Committee:
Abe Fingerhut (France), Peter Go (Chairman; The Netherlands), Adrian Grant (Project Leader; UK), Andrew Kingsnorth (UK), Jesús Merello (Spain), Paddy O'Dwyer (UK), John Payne (USA). The Secretariat:
Adrian Grant (UK), Kirsty McCormack (UK), Sue Ross (UK), Neil Scott (UK), Luke Vale (UK) The Collaborators:
Petri Aitola (Finland), Bo Anderberg (Sweden), Dag Arvidsson (Sweden), Jeffrey Barkun (Canada), Richard Barth Jnr (USA), Morten Bay-Nielsen (Denmark), Geerard Beets (The Netherlands), Reinhard Bittner (Germany), Sven Bringman (Sweden), Torben Callesen (Denmark), Carlo Castoro (Italy), Coala Trial Steering Committee (The Netherlands), Carmen Dirksen (The Netherlands), Charles Filipi (USA), Robert Fitzgibbons (USA), Esbern Friis (Denmark), Ricardo Girão (Portugal), Paul Graham (UK), Efthimios Hatzitheoklitos (Greece), Philippe Hauters (Belgium), Timo Heikkinen (Finland), Hans Jeekel (The Netherlands), Bo Johansson (Sweden), Poul Juul (Denmark), Anders Kald (Sweden), Henrik Kehlet (Denmark), Najib Khoury (Canada), Anton Klingler (Austria), J Köninger (Germany), Robert Kozol (USA), Bernhard Leibl (Germany), Ian Macintyre (UK), Guy Maddern (Australia), James McGillicuddy (USA), Bertrand Millat (France), Erik Nilsson (Sweden), Pär Nordin (Sweden), Alessandro Paganini (Italy), Giuseppe Pappalardo (Italy), Joan Sala Pedrós (Spain), Leopoldo Sarli (Italy), Rainer Schmitz (Germany), Peter Schrenk (Austria), Andreas Schwarz (Germany), Mark Sculpher (UK), Siegfried Shah (Germany), Zbigniew Sledzinski (Poland), Maciej Smietanski (Poland), David Stoker (UK), Arthur Tanner (Ireland), Chanvit Tanphiphat (Thailand), Robert Taylor (UK), Jürgen Treckmann (Germany), Jerome Tschudi (Switzerland), Francesc Vallribera (Spain), Petrousjka van den Tol (The Netherlands), Wietske Vrijland (The Netherlands), James Wellwood (UK), Piotr Witkowski (Poland), Jürgen Zieren (Germany). We thank Jayne Tierney and Lesley Stewart (Meta-analysis group, MRC Clinical Trials Unit) for advice and help with the individual patient data meta-analysis. We thank Glaxo Welcome for donating accommodation for the second collaborators meeting in Madrid, Spain, 3 November 1999. We thank Karen Forrest and Lynne Jarvis for their assistance with data input. We also thank the many people that have provided secretarial, re-coding and computing support for the organisations and groups that collaborated in the meta-analysis. We thank Janet Wale, CCNet-Contact, for the synopsis.
Publisher Copyright:
Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
PY - 2003/1/20
Y1 - 2003/1/20
N2 - Background: Inguinal hernia repair is the most frequently performed operation in general surgery. The standard method for inguinal hernia repair had changed little over a hundred years until the introduction of synthetic mesh. This mesh can be placed by either using an open approach or by using a minimal access laparoscopic technique. Although many studies have explored the relative merits and potential risks of laparoscopic surgery for the repair of inguinal hernia, most individual trials have been too small to show clear benefits of one type of surgical repair over another. Objectives: To compare minimal access laparoscopic mesh techniques with open techniques. Search methods: We searched MEDLINE, EMBASE, and The Cochrane Central Controlled Trials Registry for relevant randomised controlled trials. The reference list of identified trials, journal supplements, relevant book chapters and conference proceedings were searched for further relevant trials. Through the EU Hernia Trialists Collaboration (EUHTC) communication took place with authors of identified randomised controlled trials to ask for information on any other recent and ongoing trials known to them. Selection criteria: All published and unpublished randomised controlled trials and quasi-randomised controlled trials comparing laparoscopic groin hernia repair with open groin hernia repair were eligible for inclusion. Data collection and analysis: Individual patient data were obtained, where possible, from the responsible trialist for all eligible studies. Where IPD were unavailable additional aggregate data were sought from trialists and published aggregate data checked and verified by the trialists. Where possible, time to event analysis for hernia recurrence and return to usual activities were performed on an intention to treat principle. The main analyses were based on all trials. Sensitivity analyses based on the data source and trial quality were also performed. Pre-defined subgroup analyses based on recurrent hernias, bilateral hernias and femoral hernias were also carried out. Main results: Forty-one eligible trials of laparoscopic versus open groin hernia repair were identified involving 7161 participants (with individual patient data available for 4165). Meta-analysis was performed, using individual patient data where possible. Operation times for laparoscopic repair were longer and there was a higher risk of rare serious complications. Return to usual activities was faster, and there was less persisting pain and numbness. Hernia recurrence was less common than after open non-mesh repair but not different to open mesh methods. Authors' conclusions: The review showed that laparoscopic repair takes longer and has a more serious complication rate in respect of visceral (especially bladder) and vascular injuries, but recovery is quicker with less persisting pain and numbness. Reduced hernia recurrence of around 30-50% was related to the use of mesh rather than the method of mesh placement.
AB - Background: Inguinal hernia repair is the most frequently performed operation in general surgery. The standard method for inguinal hernia repair had changed little over a hundred years until the introduction of synthetic mesh. This mesh can be placed by either using an open approach or by using a minimal access laparoscopic technique. Although many studies have explored the relative merits and potential risks of laparoscopic surgery for the repair of inguinal hernia, most individual trials have been too small to show clear benefits of one type of surgical repair over another. Objectives: To compare minimal access laparoscopic mesh techniques with open techniques. Search methods: We searched MEDLINE, EMBASE, and The Cochrane Central Controlled Trials Registry for relevant randomised controlled trials. The reference list of identified trials, journal supplements, relevant book chapters and conference proceedings were searched for further relevant trials. Through the EU Hernia Trialists Collaboration (EUHTC) communication took place with authors of identified randomised controlled trials to ask for information on any other recent and ongoing trials known to them. Selection criteria: All published and unpublished randomised controlled trials and quasi-randomised controlled trials comparing laparoscopic groin hernia repair with open groin hernia repair were eligible for inclusion. Data collection and analysis: Individual patient data were obtained, where possible, from the responsible trialist for all eligible studies. Where IPD were unavailable additional aggregate data were sought from trialists and published aggregate data checked and verified by the trialists. Where possible, time to event analysis for hernia recurrence and return to usual activities were performed on an intention to treat principle. The main analyses were based on all trials. Sensitivity analyses based on the data source and trial quality were also performed. Pre-defined subgroup analyses based on recurrent hernias, bilateral hernias and femoral hernias were also carried out. Main results: Forty-one eligible trials of laparoscopic versus open groin hernia repair were identified involving 7161 participants (with individual patient data available for 4165). Meta-analysis was performed, using individual patient data where possible. Operation times for laparoscopic repair were longer and there was a higher risk of rare serious complications. Return to usual activities was faster, and there was less persisting pain and numbness. Hernia recurrence was less common than after open non-mesh repair but not different to open mesh methods. Authors' conclusions: The review showed that laparoscopic repair takes longer and has a more serious complication rate in respect of visceral (especially bladder) and vascular injuries, but recovery is quicker with less persisting pain and numbness. Reduced hernia recurrence of around 30-50% was related to the use of mesh rather than the method of mesh placement.
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U2 - 10.1002/14651858.CD001785
DO - 10.1002/14651858.CD001785
M3 - Article
C2 - 12535413
AN - SCOPUS:0037265142
VL - 2010
JO - Cochrane Database of Systematic Reviews
JF - Cochrane Database of Systematic Reviews
SN - 1465-1858
IS - 1
M1 - CD001785
ER -