Suture mesh fixation versus glue mesh fixation in open inguinal hernia repair: A systematic review and meta-analysis

Objective: To systematically analyse the trials comparing suture mesh fixation (SMF) versus glue mesh fixation (GMF) in open inguinal hernia repair (OIHR). Methods: Trials comparing the SMF versus GMF in OIHR were analysed systematically using RevMan (R), and combined outcomes were expressed as risk ratio (RR) and standardised mean difference (SMD). Results: Seven randomised controlled trials encompassing 1259 patients were retrieved from the electronic databases. There were 628 patients in the SMF group and 653 patients in the GMF group. In the meta-analysis, postoperative complications (RR, 1.07; 95% CI, 0.72, 1.58; z = 0.34; p = 0.74), postoperative pain (SMD, 0.31; 95% CI, -0.03, 0.64; z = 1.81; p = 0.07), chronic groin pain (RR, 1.60; 95% CI, 0.78, 3.28; z = 1.28; p = 0.20) and length of hospital stay (SMD, 0.06; 95% CI, -0.08, 0.20; z = 0.82; p = 0.41) were statistically comparable between two techniques of mesh fixation in OIHR. However, GMF was associated with a reduced operating time (SMD, 0.15; 95% CI, 0.03, 0.26; z = 2.38; p = 0.02). Conclusion: GMF is comparable to SMF in terms of postoperative complications, postoperative pain, chronic groin pain and length of hospital stay. GMF is associated with a reduced operative time compared with SMF. Based on the results of this review the GMF approach may be considered as an alternative for mesh fixation in OIHR. Results should be interpreted cautiously due to relatively short follow up time in studies. A major, multicentre randomised, controlled trial is required to validate these findings. (C) 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.