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Sapiyeva ST, Abatov NT, Aliyakparov MT, Badyrov RM, Yoshihiro N, Brizitskaya LV, Yesniyazov DK, Yukhnevich YA. Non-mesh inguinal hernia repair: Review. Asian J Surg 2024:S1015-9584(24)01272-7. [PMID: 38960759 DOI: 10.1016/j.asjsur.2024.06.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/13/2024] [Accepted: 06/19/2024] [Indexed: 07/05/2024] Open
Abstract
Hernioplasty stands as one of the most common abdominal surgical interventions. The "gold standard" treatment for inguinal hernias remains Lichtenstein mesh hernioplasty. Nonetheless, clinical practice continues to grapple with issues concerning complications such as recurrence, chronic postoperative pain, and infection. The myriad types of surgery lead to conflicting opinions regarding the superiority and drawbacks of inguinal canal plastic surgery methods. This article presents current data on the surgical treatment of non-mesh inguinal hernias, delineating the most prevalent techniques while exploring their respective advantages and disadvantages. Additionally, the researchers' experiences are analyzed in detail.
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Affiliation(s)
- S T Sapiyeva
- Department of Surgery, Non-commercial Joint-stock Company "Karaganda Medical University", Karaganda, 100000, Kazakhstan
| | - N T Abatov
- Department of Surgery, Non-commercial Joint-stock Company "Karaganda Medical University", Karaganda, 100000, Kazakhstan
| | - M T Aliyakparov
- Department of Surgery, Non-commercial Joint-stock Company "Karaganda Medical University", Karaganda, 100000, Kazakhstan
| | - R M Badyrov
- Department of Surgery, Non-commercial Joint-stock Company "Karaganda Medical University", Karaganda, 100000, Kazakhstan
| | - N Yoshihiro
- Department of Surgery, Non-commercial Joint-stock Company "Karaganda Medical University", Karaganda, 100000, Kazakhstan
| | - L V Brizitskaya
- Department of Surgery, Non-commercial Joint-stock Company "Karaganda Medical University", Karaganda, 100000, Kazakhstan
| | - D K Yesniyazov
- Department of Surgery, Non-commercial Joint-stock Company "Karaganda Medical University", Karaganda, 100000, Kazakhstan
| | - Y A Yukhnevich
- Department of Surgery, Non-commercial Joint-stock Company "Karaganda Medical University", Karaganda, 100000, Kazakhstan.
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Yerxa J, Wang H, Pappas TN. A "New" Nonmesh Technique for Inguinal Hernia Repair: Revisiting E. Wyllys Andrews and His Imbricating Operation. ANNALS OF SURGERY OPEN 2023; 4:e310. [PMID: 37746612 PMCID: PMC10513125 DOI: 10.1097/as9.0000000000000310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 06/01/2023] [Indexed: 09/26/2023] Open
Abstract
The use of prosthetic mesh to repair inguinal hernias has been common practice at surgical centers around the world for more than 30 years. Open tissue repairs are the alternative for patients who cannot have, do not want, or are not offered mesh. Open tissue repairs are troubled by inferior recurrence rates in most clinical trials. In this article, we will review a long-forgotten tissue repair described by Andrews in 1895. In addition, we report on our early experience with the Andrews technique for primary inguinal hernia tissue repair.
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Affiliation(s)
- John Yerxa
- From the Trauma and Acute Care Surgery, University of Miami/Jackson Health System, Miami, FL
| | - Hanghang Wang
- Division of Thoracic Surgery, Johns Hopkins University Medical Center, Baltimore, MD
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Chen B, Li J, Huang Y, Tang B, Jiang J, Chen Z, Li J, Wang P, Cao D, Liu L, Wei Q. The role of cytoreductive nephrectomy in metastatic renal cell carcinoma in the targeted therapy and immunological therapy era: a systematic review and meta-analysis. Int J Surg 2023; 109:982-994. [PMID: 36974696 PMCID: PMC10389335 DOI: 10.1097/js9.0000000000000314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/20/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND The role of cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC) remains controversial. In addition, several unanswered questions regarding the use of CN remain: Can CN provide survival benefits for patients with mRCC? Where do we place CN in the treatment sequence paradigm among patients with mRCC? How do we best stratify patients with mRCC for CN therapy? MATERIALS AND METHODS A search strategy was conducted in the PubMed, Embase, and Web of Science databases. Studies were included only in the English language. The risk of bias assessment was made by using ROBINS-I (Risk of Bias in Nonrandomized Studies of Interventions) and RoB 2 (Risk of Bias 2) tools. The expected outcomes were analyzed by meta-analyses with the fixed-effects model or random effects model, including overall survival (OS) and progression-free survival (PFS). The measure of effect was the hazard ratio (HR) with a 95% CI, and sensitivity analysis was conducted to assess the reliability of the final results. RESULTS A total of 30 studies were included in the qualitative analysis. The HR for OS was 0.55 (95% CI, 0.50-0.61), and PFS was 0.72 (95% CI, 0.66-0.80), favoring CN compared with no CN. The upfront CN plus targeted therapy (TT) group had superior OS (HR, 0.57; 95% CI, 0.51-0.64) compared with the TT alone group. Furthermore, upfront CN plus systemic therapy (ST) was associated with numerically inferior OS compared with ST plus deferred CN in patients with mRCC (HR, 1.31; 95% CI, 0.98-1.74). Finally, the leave-one-out test of sensitivity analysis indicated that the results of this meta-analysis were stable and reliable in the overall HR estimates for these survival outcomes. CONCLUSIONS First, CN was associated with better survival than no CN in patients with mRCC. Second, the combination of upfront CN and TT may lead to superior survival outcomes compared to TT alone in patients with mRCC. Survival outcomes were similar between the upfront CN+ST group and the ST+deferred CN group in patients with mRCC. Exact patient selection based on baseline prognostic factors is needed to promise maximal survival for patients with mRCC.
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Affiliation(s)
- Bo Chen
- Department of Urology
- Institution of Urology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Jinze Li
- Department of Urology
- Institution of Urology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Yin Huang
- Department of Urology
- Institution of Urology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Bo Tang
- Department of Urology
- Institution of Urology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Jinjiang Jiang
- Department of Urology
- Institution of Urology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Zeyu Chen
- Department of Urology
- Institution of Urology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Jin Li
- Department of Urology
- Institution of Urology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Puze Wang
- Department of Urology
- Institution of Urology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Dehong Cao
- Department of Urology
- Institution of Urology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Liangren Liu
- Department of Urology
- Institution of Urology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Qiang Wei
- Department of Urology
- Institution of Urology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
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Philipp M, Leuchter M, Lorenz R, Grambow E, Schafmayer C, Wiessner R. Quality of Life after Desarda Technique for Inguinal Hernia Repair-A Comparative Retrospective Multicenter Study of 120 Patients. J Clin Med 2023; 12:jcm12031001. [PMID: 36769652 PMCID: PMC9917682 DOI: 10.3390/jcm12031001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
Inguinal hernia repair, according to Desarda, is a pure tissue surgical technique using external oblique fascia to reinforce the posterior wall of the inguinal canal. This has provided an impetus for the rethinking of guideline adherence toward minimally invasive and mesh-based surgery of inguinal hernia. In this study, a retrospective analysis of this technique was conducted in two German hospitals. Between 6/2013 and 12/2020, 120 operations were performed. Analysis included patient characteristics, duration of operation, length of hospital stay, and perioperative complications. Data were used to achieve a matched-pair analysis comparing Desarda to laparoscopic transabdominal preperitoneal (TAPP) hernia repair. Propensity scores were calculated based on five preoperative variables, including sex, age, American Society of Anesthesiology classification, localization, and width of the inguinal hernia in order to achieve comparability. Additionally, we assessed pain level and quality of life (QoL) 12 months postoperatively. The focus of our study was a comparison of QoL to a reference population and TAPP cohort. The study population consisted of 106 male and 14 female patients, and the median age was 37.5 years. The median operation time was 50 min, and the median length of hospital stay was 2 days. At a follow-up of 17 months, the median recurrence rate was 0.8%, and two cases of chronic postoperative pain were recorded. Postoperative QoL does not significantly differ between Desarda and TAPP. In contrast, Desarda patients had a significantly higher QoL compared with the reference population. In summary, Desarda's procedure is a good option as a pure tissue method for inguinal hernia repair.
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Affiliation(s)
- Mark Philipp
- Department of General, Visceral, Thoracic, Vascular and Transplantation Surgery, Rostock University Medical Center, 18057 Rostock, Germany
- Correspondence:
| | - Matthias Leuchter
- Department of General, Visceral, Thoracic, Vascular and Transplantation Surgery, Rostock University Medical Center, 18057 Rostock, Germany
- Institute for Implant Technology and Biomaterials-IIB E.V, Associated Institute of the University of Rostock, 18119 Warnemuende, Germany
| | - Ralph Lorenz
- 3+ Chirurgen, Berlin-Spandau, 13581 Berlin, Germany
| | - Eberhard Grambow
- Department of General, Visceral, Thoracic, Vascular and Transplantation Surgery, Rostock University Medical Center, 18057 Rostock, Germany
| | - Clemens Schafmayer
- Department of General, Visceral, Thoracic, Vascular and Transplantation Surgery, Rostock University Medical Center, 18057 Rostock, Germany
| | - Reiko Wiessner
- Department of General and Visceral Surgery, Bodden-Kliniken Ribnitz-Damgarten, 18311 Ribnitz-Damgarten, Germany
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Hajibandeh S, Hajibandeh S, Evans L, Havard T, Naguib NN, Helmy AH. Meta-analysis of the outcomes of Trans Rectus Sheath Extra-Peritoneal Procedure (TREPP) for inguinal hernia. Author's reply. Hernia 2022; 26:1197-1198. [PMID: 35616753 DOI: 10.1007/s10029-022-02636-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 04/28/2022] [Indexed: 11/04/2022]
Affiliation(s)
- S Hajibandeh
- Department of General Surgery, University Hospital of Wales, Cardiff & Vale NHS Trust, Cardiff, UK.
| | - S Hajibandeh
- Hepatobiliary and Pancreatic Surgery and Liver Transplant Unit, Queen Elizabeth Hospital, Birmingham, UK
| | - L Evans
- Department of General Surgery, Royal Glamorgan Hospital, Cwm Taf University Health Board, Pontyclun, UK
| | - T Havard
- Department of General Surgery, Royal Glamorgan Hospital, Cwm Taf University Health Board, Pontyclun, UK
| | - N N Naguib
- Department of General Surgery, Royal Glamorgan Hospital, Cwm Taf University Health Board, Pontyclun, UK
| | - A H Helmy
- Department of General Surgery, Royal Glamorgan Hospital, Cwm Taf University Health Board, Pontyclun, UK.,Theodor Bilharz Research Institute, Giza, Imbaba, Egypt
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Inguinal hernia – epidemiology, risk factors, treatment methods (literature review). ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.4.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Inguinal hernias (IH) are widespread in the human population and occur in 27–43 % of men and 3–6 % of women. Many risk factors for IH have been overestimated in the last decade: male gender is considered the leading factor (the ratio between men and women is approximately 1:7), less significant factors are heredity (most significant for women), physical activity (more significant for men), age (peak prevalence of IH occurs at 5 years and 70–80 years), congenital or acquired connective tissue dysplasia, history of prostatectomy, low body mass index.Hernioplasty with the use of synthetic mesh prostheses remains the most popular technique for surgical correction of IH. Performing non-prosthetic hernioplasty is only recommended if mesh prostheses are not available, for example in poor countries. In open hernioplasty using mesh prostheses, different methods are used today: Plug & Patch, Prolene Hernia System, Parietene Progrip, sutureless plastic according to Trabucco, Stoppa, preperitoneal techniques TIPP (trans-inguinal pre-peritoneal), TREPP (transrectus pre-peritoneal), TEP (total extraperitoneal), however, none of them showed significant advantages over the gold standard of open hernioplasty – tensionfree repair according to Liechtenstein.Laparoscopic IH correction is represented by the TAPP (transabdominal preperitoneal) technique, performed through the abdominal cavity, and TEP (total extraperitoneal) – extraperitoneal prosthetic hernioplasty. None of them has a significant advantage in the treatment of IH; therefore, when choosing a treatment method, the surgeon should be guided by the cost of the operation and the level of proficiency in one or another hernioplasty technique.
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Martín Duce A, Lozano O, Galván M, Muriel A, Villeta S, Gómez J. Results of Shouldice hernia repair after 18 years of follow-up in all the patients. Hernia 2021; 25:1215-1222. [PMID: 34009507 DOI: 10.1007/s10029-021-02422-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/30/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Evaluate the long-term efficacy of the Shouldice technique performed by non-specialized surgeons and also to reflex on the quality parameters necessary to safely assess hernia recurrence rates. METHODS During 3 years, a prospective study was conducted in 243 adult men who underwent surgery for primary inguinal hernias by 13 junior surgeons with an interest in hernia surgery. Using local anesthesia, a classic 4 step Shouldice repair, with polypropylene or polyester, was performed. All patients were followed for 18 years. The follow-up met the nine quality criteria proposed by the authors. RESULTS At 18 years, 80.2% of patients were followed and only 6.5% were lost. There were 7 recurrences in the first 10 years, 5 of them secondary to a direct hernia, and the same after 18 years. The recurrence rate was 2.88%. Tolerance of the local anesthesia was excellent in 91.4%of patients and, after 3 years, the pain was considered moderate or severe in 4 patients (1.8%). CONCLUSIONS It is necessary to incorporate more demanding criteria in the assessment of recurrence, to give more valid results. The Shouldice technique remains a useful technique today not only in patients under 30 years of age, and in the absence of risk factors, but also in cases of intolerance, patient rejection or absence of mesh. In addition, it provides the clinical and economic advantages of being possible to perform it under local anesthesia.
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Affiliation(s)
- A Martín Duce
- Faculty of Medicine and Health Sciences, Alcalá University, Plaza de San Diego s/n, 28801, Alcalá de Henares, Madrid, Spain. .,Department of General Surgery, Príncipe de Asturias University Hospital, Madrid, Spain.
| | - O Lozano
- Department of General Surgery, Los Arcos del Mar Menor University Hospital, San Javier, Spain
| | - M Galván
- Department of General Surgery, Los Arcos del Mar Menor University Hospital, San Javier, Spain
| | - A Muriel
- Faculty of Medicine and Health Sciences, Alcalá University, Plaza de San Diego s/n, 28801, Alcalá de Henares, Madrid, Spain.,Biostatistics Department, Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS, CIBERESP, Ramón y Cajal University Hospital, Madrid, Spain
| | - S Villeta
- Faculty of Medicine and Health Sciences, Alcalá University, Plaza de San Diego s/n, 28801, Alcalá de Henares, Madrid, Spain
| | - J Gómez
- Faculty of Medicine and Health Sciences, Alcalá University, Plaza de San Diego s/n, 28801, Alcalá de Henares, Madrid, Spain
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Non-mesh Desarda Technique Versus Standard Mesh-Based Lichtenstein Technique for Inguinal Hernia Repair: A Systematic Review and Meta-analysis. World J Surg 2021; 44:3312-3321. [PMID: 32440951 DOI: 10.1007/s00268-020-05587-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND The aims of the present systematic review and meta-analysis were to compare non-mesh Desarda technique with standard mesh-based Lichtenstein technique for inguinal hernia repair. METHODS A systematic literature search for RCTs comparing between DT and LT was conducted using electronic databases and Google scholar service. Studies were evaluated for recurrence and post-operative complications. We pooled the data using fixed effects model and random effects model after assessing the heterogeneity among the included studies. RESULTS A total number of 8 RCTs studies were included in this meta-analysis with total number of 3177 patients divided between Desarda group and Lichtenstein group as follows: 1551 patients and 1,626 patients, respectively. There was no difference in terms of recurrence between the Desarda repair and Lichtenstein repair groups [P = 0.44]. There was a lower rate of overall post-operative complications [P = 0.003], seroma [P = 0.0004] and surgical site infections (SSIs) [P = 0.04] in the Desarda group. CONCLUSION DT and LT were found to have comparable results in terms of recurrence rate, haematoma formation, testicular atrophy and time to return to normal daily activity/work. DT is superior to LT in terms of reducing post-operative mesh-attributed complications, such as SSI and Seroma formation.
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Wilcox AR, Trooboff SW, Wong SL. Evaluating Patient-Reported Outcomes in Inguinal Hernia Clinical Trials. J Surg Res 2019; 244:430-435. [DOI: 10.1016/j.jss.2019.06.055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/30/2019] [Accepted: 06/14/2019] [Indexed: 02/06/2023]
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