A Meta-Analysis Of The Clinical Efficacy Of Tension-Free Repair And Bassini Repair In The Treatment Of Incarcerated Inguinal Hernia In Adult

Objective:Meta-analysis was used to investigate the clinical effect of tension-free repair versus Bassini repair for incarcerated inguinal hernia.Methods:According to the research content,the related keywords and free words were locked in PubMed,Embase,Geenmedical,HowNet and Wanfang database.From January 2005 to January 2019,the tension-free repair of patch was compared with Bassini repair in the treatment of incarcerated inguinal hernia.Relevant literature on efficacy,screening for qualified documents based on inclusion and exclusion criteria.Quality assessment of the primary selection literature,selection of high quality literature,and extraction of target data.Finally,the meta-review was performed by using software of Review Manager 5.3.Results:A total of 8 domestic and 3 foreign literatures were collected,for a total of 834 patients.Among them,387 patients(observation group)were treated with plain tension-free repair(Lichistein),and 447 patients(control group)were treated with Bassini surgery.By analysis of the relevant clinical results of the above patients,it was found the operation time in the observation group was less than that of in the control group(WMD=-10.52,95% CI:-14.94~-6.10;P<0.00001);The observation group was also shorter(WMD =-14.95,95% CI:-22.25 to 7.66;P < 0.0001);the length of hospital stay was also short(WMD =-2.30,95% CI:-3.81 to 0.78;P = 0.003).In terms of postoperative complications,the incision infection rate was low in the observation group compared with the control group(OR=0.45,95% CI: 0.22 to 0.90,P=0.02);After 3 months of follow-up,the recurrence rate of the observation group was also low(OR=0.17 95% CI: 0.08-0.35 P<0.00001).There was no statistically significant difference between the two groups in terms of scrotal hematoma,urinary retention and subcutaneous fluid accumulation.Conclusion:Tension-free repair for adult incarcerated inguinal hernia/indirect necrosis(no intestinal necrosis)does not increase the risk of surgical incision infection,but will shorten the patient's time of getting out of bed and hospital stay.In terms of postoperative recurrence rate,tension-free repair is significantly lower than Bassini repair.Therefore,incarcerated inguinal oblique/straight sacral tension-free repair is safe and feasible without obvious infection.