Cyanoacrylate Glue Versus Absorbable Tacks in Mesh Fixation for Laparoscopic Extraperitoneal Inguinal Hernia Repair: A Randomized Controlled Trial

Safety and efficacy revisited: a systematic review and meta-analysis of glue versus tack mesh fixation in laparoscopic inguinal herniorrhaphy

Background

This analysis addresses the uncertainty surrounding the efficacy of glue mesh fixation (GMF) compared with tack mesh fixation (TMF) in laparoscopic herniorrhaphy. Our meta-analysis incorporates recently conducted randomized controlled trials (RCTs) to enhance the reference for assessing the efficacy and safety of GMF.

Methods

PubMed Central, Google Scholar, Science Direct, and Cochrane Library were extensively reviewed for articles in the English language performed from inception to May 2023 using the keywords "Glue mesh repair," "Tack mesh repair," "Inguinal Hernia," "Herniorrhaphy," "Laparoscopic," "Mesh Fixation," and "Randomized controlled trials."

Results

In this meta-analysis, we incorporated a total of 20 randomized controlled trials, evaluating each article individually using quality ratings. Compared with TMF, GMF demonstrated a significant reduction in the incidence of chronic pain [RR: 0.40, (0.23, 0.68)] and pain scores on postoperative day 1 [MD: -1.07, (-1.90, -0.25)]. We also used funnel plots and Egger's regression to test for publication bias.

Conclusion

In summary, this meta-analysis establishes the significance of GMF in reducing chronic pain and postoperative day 1 pain compared with TMF. However, no statistically significant difference was noted between the GMF and TMF groups concerning hematoma, seroma, operation time, recurrence rate, and total complications. Nonetheless, given the small number of cases in this study, the findings must be validated in the future by multicenter, large-sample, high-quality RCTs.

Application Effect of Combining Image-Text Communication-Based Healthcare Education with Shifting of Attention on Child Patients Undergoing Inguinal Hernia Repair under General Anesthesia

Objective

To analyze the application effect of image-text communication-based healthcare education combined with shifting of attention on child patients undergoing inguinal hernia repair under general anesthesia.

Methods

A total of 110 child patients with inguinal hernia treated in our hospital from January 2020 to January 2022 were selected as the study subjects and divided into the control group (CG, routine intervention measures) and the research group (RG, image-text communication-based healthcare education combined with shifting of attention) according to their preoperative intervention plans, with 55 cases each. After surgery, the child patients' psychological status, crying and shouting situation, and occurrence of complications were evaluated to compare and analyze the intervention effect of the two groups.

Results

The child patients' positive rate and anxiety incidence rate of psychological status evaluation were obviously lower in RG than in CG (P < 0.05), and the daily frequency of crying and shouting was significantly lower in RG than in CG (P < 0.05); the single time of crying and shouting was significantly shorter in RG than in CG (P < 0.05); after surgery, child patients in the two groups had different degrees of infections, subcutaneous emphysema, and scrotal edema, but the total incidence rate of these complications was obviously lower in RG than in CG (P < 0.05); after surgery, no significant between-group difference in child patients' FLACC scores immediately after being transferred to the ward was observed (P > 0.05), and at postoperative 1 h, 3 h, and 5 h, the FLACC scores of RG were obviously lower than those of CG (P < 0.05); and according to the investigation results, the total satisfaction and number of very satisfied parents in RG were greatly higher than those in CG (P < 0.05).

Conclusion

Before child patients undergoing inguinal hernia repair under general anesthesia, implementing image-text communication-based healthcare education combined with shifting of attention can effectively improve the child patients' postoperative psychological status and crying and shouting situation and is conducive to preventing postoperative infections, pain, and other complications and promoting postoperative recovery. The combined intervention has potential utility in reducing child patients' high-risk adverse reactions during the perioperative period and ensuring smooth operation, which is generally recognized by the child patients' family members.