Shouldice technique versus other open techniques for inguinal hernia repair
Sübutlu məlumatların xülasələri
01.09.2015 • Sonuncu dəyişiklik 01.09.2015
Editors
Shouldice technique appears to be the best non-mesh method of inguinal hernia repair in terms of recurrence. The use of mesh reduces recurrence even more.
A Cochrane review included 16 studies with a total of 5411 subjects. Only 3% of the included patients were female. The length of follow-up varied broadly among the studies from 1 year to 13.7 years. The recurrence rate with Shouldice techniques was higher than mesh techniques (3.6% vs. 0.8%; OR 3.80, 95% CI 1.99 to 7.26; 6 studies, n=1565) but lower than non-mesh techniques (4.4% vs. 6.9%; OR 0.62, 95% CI 0.45 to 0.85; 8 studies, n= 2865). There were no significant differences in chronic pain, complications and post-operative stay.
A systematic review
including 9 prospective controlled trials (7 randomised trials and 2 non-randomised trials) with a total of 3 633 subjects was abstracted in DARE. Recurrence rates were lower after Shouldice repair in 10 of 11 studies. In five of the 11 studies the difference was significant. Pooling the 6 studies with highest quality scores, the risk ratio of recurrence was 0.62 (95% CI 0.44 to 0.87) in favour of the Shouldice technique.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment, lack of blinding, and inadequate intention-to-treat adherence).
Ədəbiyyat
-
Simons MP, Kleijnen J, van Geldere D, Hoitsma HF, Obertop H. Role of the Shouldice technique in inguinal hernia repair: a systematic review of controlled trials and a meta-analysis. Br J Surg 1996 Jun;83(6):734-8.
- Amato B, Moja L, Panico S et al. Shouldice technique versus other open techniques for inguinal hernia repair. Cochrane Database Syst Rev 2012;(4):CD001543. .