Open mesh versus non-mesh repair of groin hernia meta-analysis of randomized trials leased on individual patient data

Background: The EU Hernia Trialists Collaboration was established to provide reliable evaluation of newer methods of groin hernia repair. It involved 70 investigators in 20 countries. Materials and methods: Twenty eligible trials (5016 participants) of open mesh vs. non-mesh groin hernia repair were identified. Meta-analysis was performed using raw individual patient data where possible. Results: Fewer hernia recurrences were reported after mesh repair. There were no clear differences between mesh and non-mesh groups in complications. Overall, those in the mesh groups had a shorter hospital stay, quicker return to usual activities and less frequent persisting pain, but individual trial results varied. Conclusions: The review provides strong evidence that open mesh repair is associated with a reduction in the risk of recurrence of between 50% and 75%. There is also some evidence of quicker recovery and of lower rates of persisting pain following open mesh repair.A.M. Grant (Guy John Maddern one of several collaborators

Laparoscopic versus open groin hernia repair: meta-analysis of randomised trials based on individual patient data

The EU Hernia Trialists Collaboration was established to provide reliable evaluation of newer methods of groin hernia repair. It involved 70 investigators in 20 countries. The aim was to perform systematic reviews and enhance the value of individual studies by reanalysis of data from randomised controlled trials in meta-analyses. Forty-one eligible trials of laparoscopic versus open groin hernia repair were identified involving 7161 participants (with individual patient data available for 4165). Meta-analysis was performed, using individual patient data where possible. Operation times for laparoscopic repair were longer and there was a higher risk of rare serious complications. Return to usual activities was faster, and there was less persisting pain and numbness. Hernia recurrence was less common than after open non-mesh repair but not different to open mesh methods. The review showed that laparoscopic repair takes longer and has more serious complications, but recovery is quicker with less persisting pain. Reduced hernia recurrence was related to the use of mesh rather than the method of mesh placement.The EU Hernia Trialists Collaboratio