Student or educator? Sign up with your school email and get 6 months of Pro free.
CoChat
Sign Up
Cited by 51

The DOI matches its Crossref record; 1 of the 1 references it cites were found in a registry or an index.

Heavyweight mesh is superior to lightweight mesh in laparo-endoscopic inguinal hernia repair: a meta-analysis and trial sequential analysis of randomized controlled trials.

Bakker, Wouter J., Aufenacker, Theo J., Boschman, Julitta S., Burgmans, Josephina P. J.·2021·Annals of Surgery
DOI 10.1097/sla.0000000000003831
Open this paper in CoChat — free account

Abstract

Objective: This meta-analysis and trial sequential analysis aims to provide an update on the available randomized controlled trials (RCTs) and recommendations on using lightweight mesh (LWM) or heavyweight mesh (HWM) in laparo-endoscopic inguinal hernia repair. Background: LWM might reduce chronic pain through improved mesh flexibility and less fibrosis formation. However, in laparo-endoscopic repair chronic pain is already rare and LWM raise concerns of higher recurrence rates. Methods: A literature search was conducted in May 2019 in MEDLINE, Embase, and the Cochrane library for RCTs that compared lightweight (≤50 g/m 2) and heavyweight (>70 g/m 2) mesh in patients undergoing laparo-endoscopic surgery for uncomplicated inguinal hernias. Outcomes were recurrences, chronic pain, and foreign-body sensation. The level of evidence was assessed using GRADE. Risk ratios (RR) and 95% confidence intervals (CI) were calculated by random effect meta-analyses. Trial-sequential-analyses were subsequently performed. Results: Twelve RCTs, encompassing 2909 patients (LWM 1490 vs HWM 1419), were included. The follow-up range was 3 to 60 months. Using LWM increased the recurrence risk (LWM 32/1571, HWM 13/1508; RR 2.21; CI 1.14–4.31), especially in nonfixated mesh direct repairs (LWM 13/180, HWM 1/171; RR 7.27; CI 1.33–39.73) and/or large hernia defects. No difference was determined regarding any pain (LWM 123/1362, HWM 127/1277; RR 0.79; CI 0.52–1.20), severe pain (LWM 3/1226, HWM 9/1079; RR 0.38; CI 0.11–1.35), and foreign-body sensation (LWM 100/1074, HWM 103/913; RR 0.94; CI 0.73–1.20). Conclusion: HWM should be used in laparo-endoscopic repairs of direct or large inguinal hernias to reduce recurrence rates. LWM provide no benefit in indirect hernias.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1097/sla.0000000000003831

Cites

1 of 1 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Research works printed but not linked: 41

  1. van Veen, 2007, Long-term follow-up of a randomized clinical trial of non-mesh versus mesh repair of primary inguinal hernia, Br J Surg, 94, 506, 10.1002/bjs.5627 · DOI
  2. Nowack, 2007, Risk of recurrence 5 years or more after primary Lichtenstein mesh and sutured inguinal hernia repair (Br J Surg 2007; 94: 1038-1040), Br J Surg, 94, 1438, 10.1002/bjs.6065 · DOI
  3. 2018, International guidelines for groin hernia management, Hernia, 22, 1, 10.1007/s10029-017-1668-x · DOI
  4. Smietanski, 2012, Systematic review and meta-analysis on heavy and lightweight polypropylene mesh in Lichtenstein inguinal hernioplasty, Hernia, 16, 519, 10.1007/s10029-012-0930-5 · DOI
  5. Sajid, 2012, Systematic review and meta-analysis of the use of lightweight versus heavyweight mesh in open inguinal hernia repair, Br J Surg, 99, 29, 10.1002/bjs.7718 · DOI
  6. Sajid, 2013, Lightweight versus Heavyweight mesh for laparoscopic repair of inguinal hernia, Cochrane Database Syst Rev, 2, 1
  7. Sajid, 2013, A systematic review and meta-analysis evaluating the effectiveness of lightweight mesh against heavyweight mesh in influencing the incidence of chronic groin pain following laparoscopic inguinal hernia repair, Am J Surg, 205, 726, 10.1016/j.amjsurg.2012.07.046 · DOI
  8. Liberati, 2009, The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration, J Clin Epidemiol, 62, e1, 10.1016/j.jclinepi.2009.06.006 · DOI · Paper page
  9. Klinge, 2012, Modified classification of surgical meshes for hernia repair based on the analyses of 1,000 explanted meshes, Hernia, 16, 251, 10.1007/s10029-012-0913-6 · DOI
  10. Zhu, 2015, Mesh implants: an overview of crucial mesh parameters, World J Gastrointest Surg, 7, 226, 10.4240/wjgs.v7.i10.226 · DOI
  11. Currie, 2012, Lightweight versus heavyweight mesh in laparoscopic inguinal hernia repair: a meta-analysis, Surg Endosc, 26, 2126, 10.1007/s00464-012-2179-6 · DOI
  12. Melkemichel, 2018, Lower recurrence rate with heavyweight mesh compared to lightweight mesh in laparoscopic totally extra-peritoneal (TEP) repair of groin hernia: a nationwide population-based register study, Hernia, 22, 989, 10.1007/s10029-018-1809-x · DOI
  13. 1986, Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Association for the Study of Pain, Subcommittee on Taxonomy, Pain Suppl, 3, S1
  14. Jadad, 1996, Assessing the quality of reports of randomized clinical trials: is blinding necessary?, Control Clin Trials, 17, 1, 10.1016/0197-2456(95)00134-4 · DOI · Paper page
  15. Burcharth, 2015, Patient-related risk factors for recurrence after inguinal hernia repair: a systematic review and meta-analysis of observational studies, Surg Innov, 22, 303, 10.1177/1553350614552731 · DOI
  16. Burgmans, 2016, Long-term results of a randomized double-blinded prospective trial of a lightweight (Ultrapro) versus a heavyweight mesh (Prolene) in laparoscopic total extraperitoneal inguinal hernia repair (TULP-trial), Ann Surg, 263, 862, 10.1097/SLA.0000000000001579 · DOI
  17. Pierides, 2016, Factors predicting chronic pain after open mesh based inguinal hernia repair: a prospective cohort study, Int J Surg, 29, 165, 10.1016/j.ijsu.2016.03.061 · DOI
  18. Wetterslev, 2017, Trial sequential analysis in systematic reviews with meta-analysis, BMC Med Res Methodol, 17, 39, 10.1186/s12874-017-0315-7 · DOI
  19. Wetterslev, 2009, Estimating required information size by quantifying diversity in random-effects model meta-analyses, BMC Med Res Methodol, 9, 10.1186/1471-2288-9-86 · DOI · Paper page
  20. Wetterslev, 2008, Trial sequential analysis may establish when firm evidence is reached in cumulative meta-analysis, J Clin Epidemiol, 61, 64, 10.1016/j.jclinepi.2007.03.013 · DOI · Paper page
  21. Champault, 2007, Inguinal hernia repair: the choice of prosthesis outweighs that of technique, Hernia, 11, 125, 10.1007/s10029-006-0179-y · DOI
  22. Langenbach, 2008, Sixty-month follow-up after endoscopic inguinal hernia repair with three types of mesh: a prospective randomized trial, Surg Endosc, 22, 1790, 10.1007/s00464-008-9863-6 · DOI
  23. Chowbey, 2010, Prospective randomized clinical trial comparing lightweight mesh and heavyweight polypropylene mesh in endoscopic totally extraperitoneal groin hernia repair, Surg Endosc, 24, 3073, 10.1007/s00464-010-1092-0 · DOI
  24. Bittner, 2011, Early postoperative and one year results of a randomized controlled trial comparing the impact of extralight titanized polypropylene mesh and traditional heavyweight polypropylene mesh on pain and seroma production in laparoscopic hernia repair (TAPP), World J Surg, 35, 1791, 10.1007/s00268-011-1148-x · DOI
  25. Bittner, 2011, One-year results of a prospective, randomised clinical trial comparing four meshes in laparoscopic inguinal hernia repair (TAPP), Hernia, 15, 503, 10.1007/s10029-011-0810-4 · DOI
  26. Peeters, 2014, Sperm motility after laparoscopic inguinal hernia repair with lightweight meshes: 3-year follow-up of a randomised clinical trial, Hernia, 18, 361
  27. Roos, 2018, Higher recurrence rate after endoscopic totally extraperitoneal (TEP) inguinal hernia repair with ultrapro lightweight mesh: 5-year results of a randomized controlled trial (TULP-trial), Ann Surg, 268, 241, 10.1097/SLA.0000000000002649 · DOI
  28. Yang, 2019, Titanium-coated mesh versus standard polypropylene mesh in laparoscopic inguinal hernia repair: a prospective, randomized, controlled clinical trial, Hernia, 23, 255, 10.1007/s10029-018-1823-z · DOI
  29. Agarwal, 2009, Prospective double-blind randomized controlled study comparing heavy- and lightweight polypropylene mesh in totally extraperitoneal repair of inguinal hernia: early results, Surg Endosc, 23, 242, 10.1007/s00464-008-0188-2 · DOI
  30. Prakash, 2016, A prospective randomised controlled trial comparing chronic groin pain and quality of life in lightweight versus heavyweight polypropylene mesh in laparoscopic inguinal hernia repair, J Minim Access Surg, 12, 154, 10.4103/0972-9941.170018 · DOI
  31. Kalra, 2017, Comparing early outcomes using non absorbable polypropylene mesh and partially absorbable composite mesh through laparoscopic transabdominal preperitoneal repair of inguinal hernia, J Clin Diagn Res, 11, C13
  32. Wong, 2018, Prospective randomized controlled trial comparing partially absorbable lightweight mesh and multifilament polyester anatomical mesh in laparoscopic inguinal hernia repair, Asian J Endosc Surg, 11, 146, 10.1111/ases.12421 · DOI
  33. Achelrod, 2014, Cost-utility analysis comparing heavy-weight and light-weight mesh in laparoscopic surgery for unilateral inguinal hernias, Appl Health Econ Health Policy, 12, 151, 10.1007/s40258-014-0082-0 · DOI
  34. Koch, 2006, Randomized prospective study of totally extraperitoneal inguinal hernia repair: fixation versus no fixation of mesh, JSLS, 10, 457
  35. Bringman, 2005, Early results of a randomized multicenter trial comparing Prolene and VyproII mesh in bilateral endoscopic extraperitoneal hernioplasty (TEP), Surg Endosc, 19, 536, 10.1007/s00464-004-9100-x · DOI
  36. Chui, 2010, Prospective, randomized, controlled trial comparing lightweight versus heavyweight mesh in chronic pain incidence after TEP repair of bilateral inguinal hernia, Surg Endosc, 24, 2735, 10.1007/s00464-010-1036-8 · DOI
  37. Heikkinen, 2006, Early results of a randomised trial comparing Prolene and VyproII-mesh in endoscopic extraperitoneal inguinal hernia repair (TEP) of recurrent unilateral hernias, Hernia, 10, 34, 10.1007/s10029-005-0026-6 · DOI
  38. Langenbach, 2006, Comparison of biomaterials: three meshes and TAPP for inguinal hernia, Surg Endosc, 20, 1511, 10.1007/s00464-005-0078-9 · DOI
  39. Peeters, 2010, Laparoscopic inguinal hernia repair in men with lightweight meshes may significantly impair sperm motility: a randomized controlled trial, Ann Surg, 252, 240, 10.1097/SLA.0b013e3181e8fac5 · DOI
  40. Franneby, 2008, Validation of an Inguinal Pain Questionnaire for assessment of chronic pain after groin hernia repair, Br J Surg, 95, 488, 10.1002/bjs.6014 · DOI
  41. Montgomery, 2012, Systematic review and meta-analysis of the use of lightweight versus heavyweight mesh in open inguinal hernia repair, Br J Surg, 99, 37, 10.1002/bjs.7769 · DOI

Cited by

See all 51

Metadata

Authors
Bakker, W. J., Aufenacker, T. J., Boschman, J. S., & Burgmans, J. P. J.
Affiliations
  • Hernia Clinic, Department of Surgery, Diakonessenhuis, Zeist, Utrecht, the Netherlands
  • Department of Surgery, Rijnstate, Arnhem, the Netherlands
  • Dutch Knowledge Institute of Medical Specialists, Utrecht, the Netherlands.
Venue
Annals of Surgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2020-03-27
Volume
273
Issue
5
Pages
890-899
ISSN
  • 0003-4932
  • 1528-1140
DOI
10.1097/sla.0000000000003831
Cited by
51
References
1
Language
en

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Data sources

Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.