Efficacy And Safety Of Mesh For Potential Contaminated Incarcerated Hernia:A Meta-analysis

Background:Incarcerated hernia is a common clinical emergency and often requires emergency surgery.However,the use of mesh in potential contamination incarcerated hernia remains controversial.Objectives:This systematic review was designed to evaluate the efficacy and safety of the use of mesh in the treatment of incarcerated hernia.Methods:We searched Embase,Pubmed,Web of Science database and China National Knowledge Infrastructure(CNKI),China Biology Medicine disc(CBM),Wanfang Database,and VIP Chinese Science and Technology Journal Database(VIP)for clinical study comparing mesh with non-mesh in adult incarcerated hernia.The study was screened by the inclusion and exclusion criteria,and the quality was evaluated by the Newcastle-Ottawa Scale(NOS)and Cochrane Handbook 5.1 bias risk assessment tools.The test data was extracted and then meta-analyzed using RevMan5.3 software.Results:A total of 1788 patients were enrolled in the study,including 827 patients in the observation group(mesh group and post-intestinal mesh repair group)and 961 patients in the control group(non-mesh group and non-intestinal mesh repair group).Meta-analysis results showed that the infection rate of incision in the mesh group and the non-mesh group [OR=1.08,95% CI(0.74,1.58),P>0.05],postoperative hospital stay [MD=-0.96,95 %CI(-3.81,1.90),P>0.05] There was no statistical significance in the comparison of differences;the difference in the recurrence rate of hernia[OR=0.15,95% CI(0.06,0.35),P<0.05] Statistically significant,the recurrence rate of postoperative hernia was lower in the mesh group than in the non-mesh group;the infection rate after bowel resection and no bowel resection mesh repair [OR=2.54,95% CI(0.82,7.91),P>0.05] Comparison differences have no statistical significance.Conclusion:The use of mesh in incarcerated/ strangulation hernia is a good choice.Compared with non-mesh,the recurrence rate after surgery is greatly reduced,and the postoperative infection rate and postoperative hospital stay are not increased.