TY - JOUR
T1 - Transinguinal preperitoneal (TIPP) versus Lichtenstein for inguinal hernia repair
T2 - a systematic review and meta-analysis
AU - Silveira, C. A.B.
AU - Poli de Figueiredo, S. M.
AU - Dias, Y. J.M.
AU - Martin, R. R.H.
AU - Rasador, A. C.D.
AU - Fernandez, M. G.
AU - Lu, R.
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
PY - 2023/12
Y1 - 2023/12
N2 - Purpose: We aimed to perform a systematic review and meta-analysis comparing postoperative outcomes in inguinal hernia repair with TIPP versus Lichtenstein technique. Methods: Cochrane Central, Scopus, and PubMed were systematically searched for studies comparing TIPP and Lichtenstein´s technique for inguinal hernia repair. Outcomes assessed were operative time, bleeding, surgical site events, hospital stay, the Visual Analogue Pain Score, chronic pain, paresthesia rates, and recurrence. Statistical analysis was performed using RevMan 5.4.1. Heterogeneity was assessed with I 2 statistics and random-risk effect was used if I 2 > 25%. Results: 790 studies were screened and 44 were thoroughly reviewed. A total of nine studies, comprising 8428 patients were included, of whom 4185 (49.7%) received TIPP and 4243 (50.3%) received Lichtenstein. We found that TIPP presented less chronic pain (OR 0.43; 95% CI 0.20–0.93 P = 0.03; I 2 = 84%) and paresthesia rates (OR 0.27; 95% CI 0.07–0.99; P = 0.05; I 2 = 63%) than Lichtenstein group. In addition, TIPP was associated with a lower VAS pain score at 14 postoperative day (MD − 0.93; 95% CI − 1.48 to − 0.39; P = 0.0007; I 2 = 99%). The data showed a lower operative time with the TIPP technique (MD − 7.18; 95% CI − 12.50, − 1.87; P = 0.008; I 2 = 94%). We found no statistical difference between groups regarding the other outcomes analyzed. Conclusion: TIPP may be a valuable technique for inguinal hernias. It was associated with lower chronic pain, and paresthesia when compared to Lichtenstein technique. Further long-term randomized studies are necessary to confirm our findings. Study registration A review protocol for this meta-analysis was registered at PROSPERO (CRD42023434909).
AB - Purpose: We aimed to perform a systematic review and meta-analysis comparing postoperative outcomes in inguinal hernia repair with TIPP versus Lichtenstein technique. Methods: Cochrane Central, Scopus, and PubMed were systematically searched for studies comparing TIPP and Lichtenstein´s technique for inguinal hernia repair. Outcomes assessed were operative time, bleeding, surgical site events, hospital stay, the Visual Analogue Pain Score, chronic pain, paresthesia rates, and recurrence. Statistical analysis was performed using RevMan 5.4.1. Heterogeneity was assessed with I 2 statistics and random-risk effect was used if I 2 > 25%. Results: 790 studies were screened and 44 were thoroughly reviewed. A total of nine studies, comprising 8428 patients were included, of whom 4185 (49.7%) received TIPP and 4243 (50.3%) received Lichtenstein. We found that TIPP presented less chronic pain (OR 0.43; 95% CI 0.20–0.93 P = 0.03; I 2 = 84%) and paresthesia rates (OR 0.27; 95% CI 0.07–0.99; P = 0.05; I 2 = 63%) than Lichtenstein group. In addition, TIPP was associated with a lower VAS pain score at 14 postoperative day (MD − 0.93; 95% CI − 1.48 to − 0.39; P = 0.0007; I 2 = 99%). The data showed a lower operative time with the TIPP technique (MD − 7.18; 95% CI − 12.50, − 1.87; P = 0.008; I 2 = 94%). We found no statistical difference between groups regarding the other outcomes analyzed. Conclusion: TIPP may be a valuable technique for inguinal hernias. It was associated with lower chronic pain, and paresthesia when compared to Lichtenstein technique. Further long-term randomized studies are necessary to confirm our findings. Study registration A review protocol for this meta-analysis was registered at PROSPERO (CRD42023434909).
KW - Inguinal hernia
KW - Lichtenstein
KW - Open preperitoneal
KW - Transinguinal preperitoneal
UR - http://www.scopus.com/inward/record.url?scp=85171386573&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85171386573&partnerID=8YFLogxK
U2 - 10.1007/s10029-023-02882-0
DO - 10.1007/s10029-023-02882-0
M3 - Review article
C2 - 37715825
AN - SCOPUS:85171386573
SN - 1265-4906
VL - 27
SP - 1375
EP - 1385
JO - Hernia
JF - Hernia
IS - 6
ER -