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dc.contributor.authorBullen, N L
dc.contributor.authorSmart, Neil J.
dc.identifier.citationBullen NL et al. Suture fixation versus self-gripping mesh for open inguinal hernia repair: a systematic review with meta-analysis and trial sequential analysis. Surg Endosc. 2020 May 22. doi: 10.1007/s00464-020-07658-6. Epub ahead of print.en_US
dc.description.abstractIntroduction: Morbidity following open inguinal hernia repair is mainly related to chronic pain. ProGrip™ is a self-gripping mesh which aims to reduce rates of chronic pain. The aim of this study is to perform an update meta-analysis to consolidate the non-superiority hypothesis in terms of postoperative pain and recurrence and perform a trial sequential analysis. Methods: Systematic review of randomised controlled trials performed according to PRISMA guidelines. Pooled odds ratios with 95% confidence intervals (CI) were calculated using the Mantel-Haenszel (M-H) method. The primary outcome measure was postoperative pain and secondary outcomes were recurrence, operative time, wound complications, length of stay, re-operation rate, and cost. Trial sequential analysis was performed. Results: There were 14 studies included in the quantitative analysis with 3180 patients randomised to self-gripping mesh (1585) or standard mesh (1595). At all follow-up time points, there was no significant difference in the rates of chronic pain between the self-gripping and standard mesh (risk ratio, RR 1.10, 95% confidence interval, CI 0.83-1.46). There were no significant differences in recurrence rates (RR 1.13, CI 0.84-2.04). The mean operating time was significantly shorted in the ProGrip™ mesh group (MD - 7.32 min, CI - 10.21 to - 4.44). Trial sequential analysis suggests findings are conclusive. Conclusion: This meta-analysis has confirmed no benefit of a ProGrip™ mesh when compared to a standard sutured mesh for open inguinal hernia repair in terms of chronic pain or recurrence. No further trials are required to address this clinical question.en_US
dc.rightsCopyright © 2020, Springer Natureen_US
dc.subjectOpen inguinal herniaen_US
dc.subjectSelf-gripping meshen_US
dc.titleSuture fixation versus self-gripping mesh for open inguinal hernia repair: a systematic review with meta-analysis and trial sequential analysien_US
dc.typeJournal Articleen_US
dc.identifier.journalSurgical Endoscopyen_US
dc.description.noteThis article is available to RD&E staff via NHS OpenAthens (Full text delay may apply) . Click on the Publisher URL, and log in with NHS OpenAthens if prompted.en_US
dc.type.versionIn press (epub ahead of print)en_US
dc.description.admin-notepublished version, accepted version (12 month embargo)en_US

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