Mesh versus non-mesh for inguinal and femoral hernia repair

Kathleen Lockhart, Douglas Dunn, Shawn Teo, Jessica Y Ng, Manvinder Dhillon, Edward Teo, Mieke L van Driel, Kathleen Lockhart, Douglas Dunn, Shawn Teo, Jessica Y Ng, Manvinder Dhillon, Edward Teo, Mieke L van Driel

Abstract

Background: This is an update of a Cochrane Review first published in 2001.Hernias are protrusions of all or part of an organ through the body wall that normally contains it. Groin hernias include inguinal (96%) and femoral (4%) hernias, and are often symptomatic with discomfort. They are extremely common, with an estimated lifetime risk in men of 27%. Occasionally they may present as emergencies with complications such as bowel incarceration, obstruction and strangulation. The definitive treatment of all hernias is surgical repair, inguinal hernia repair being one of the most common surgical procedures performed. Mesh (hernioplasty) and the traditional non-mesh repairs (herniorrhaphy) are commonly used, with an increasing preference towards mesh repairs in high-income countries.

Objectives: To evaluate the benefits and harms of different inguinal and femoral hernia repair techniques in adults, specifically comparing closure with mesh versus without mesh. Outcomes include hernia recurrence, complications (including neurovascular or visceral injury, haematoma, seroma, testicular injury, infection, postoperative pain), mortality, duration of operation, postoperative hospital stay and time to return to activities of daily living.

Search methods: We searched the following databases on 9 May 2018: Cochrane Colorectal Cancer Group Specialized Register, Cochrane Central Register of Controlled Trials (Issue 1), Ovid MEDLINE (from 1950), Ovid Embase (from 1974) and Web of Science (from 1900). Furthermore, we checked the WHO International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov for trials. We applied no language or publication restrictions. We also searched the reference lists of included trials and review articles.

Selection criteria: We included randomised controlled trials of mesh compared to non-mesh inguinal or femoral hernia repairs in adults over the age of 18 years.

Data collection and analysis: We used standard methodological procedures expected by Cochrane. Where available, we collected information on adverse effects. We presented dichotomous data as risk ratios, and where possible we calculated the number needed to treat for an additional beneficial outcome (NNTB). We presented continuous data as mean difference. Analysis of missing data was based on intention-to-treat principles, and we assessed heterogeneity using an evaluation of clinical and methodological diversity, Chi2 test and I2 statistic. We used GRADE to assess the quality of evidence for each outcome.

Main results: We included 25 studies (6293 participants) in this review. All included studies specified inguinal hernias, and two studies reported that femoral hernias were included.Mesh repair probably reduces the risk of hernia recurrence compared to non-mesh repair (21 studies, 5575 participants; RR 0.46, 95% CI 0.26 to 0.80, I2 = 44%, moderate-quality evidence). In absolute numbers, one hernia recurrence was prevented for every 46 mesh repairs compared with non-mesh repairs. Twenty-four studies (6293 participants) assessed a wide range of complications with varying follow-up times. Neurovascular and visceral injuries were more common in non-mesh repair groups (RR 0.61, 95% CI 0.49 to 0.76, I2 = 0%, NNTB = 22, high-quality evidence). Wound infection was found slightly more commonly in the mesh group (20 studies, 4540 participants; RR 1.29, 95% CI 0.89 to 1.86, I2 = 0%, NNTB = 200, low-quality evidence). Mesh repair reduced the risk of haematoma compared to non-mesh repair (15 studies, 3773 participants; RR 0.88, 95% CI 0.68 to 1.13, I2 = 0%, NNTB = 143, low-quality evidence). Seromas probably occur more frequently with mesh repair than with non-mesh repair (14 studies, 2640 participants; RR 1.63, 95% CI 1.03 to 2.59, I2 = 0%, NNTB = 72, moderate-quality evidence), as does wound swelling (two studies, 388 participants; RR 4.56, 95% CI 1.02 to 20.48, I2 = 33%, NNTB = 72, moderate-quality evidence). The comparative effect on wound dehiscence is uncertain due to wide confidence intervals (two studies, 329 participants; RR 0.55, 95% CI 0.12 to 2.48, I2 = 37% NNTB = 77, low-quality evidence). Testicular complications showed nearly equivocal results; they probably occurred slightly more often in the mesh group however the confidence interval around the effect was wide (14 studies, 3741 participants; RR 1.06, 95% CI 0.63 to 1.76, I2 = 0%, NNTB = 2000, low-quality evidence). Mesh reduced the risk of postoperative urinary retention compared to non-mesh (eight studies, 1539 participants; RR 0.53, 95% CI 0.38 to 0.73, I2 = 56%, NNTB = 16, moderate-quality evidence).Postoperative and chronic pain could not be compared due to variations in measurement methods and follow-up time (low-quality evidence).No deaths occurred during the follow-up periods reported in the seven studies (2546 participants) reporting this outcome (high-quality evidence).The average operating time was longer for non-mesh repairs by a mean of 4 minutes 22 seconds, despite wide variation across the studies regarding size and direction of effect, thus this result is uncertain (20 studies, 4148 participants; 95% CI -6.85 to -1.60, I2= 97%, very low-quality evidence). Hospital stay may be shorter with mesh repair, by 0.6 days (12 studies, 2966 participants; 95% CI -0.86 to -0.34, I2 = 98%, low-quality evidence), and participants undergoing mesh repairs may return to normal activities of daily living a mean of 2.87 days sooner than those with non-mesh repair (10 studies, 3183 participants; 95% CI -4.42 to -1.32, I2 = 96%, low-quality evidence), although the results of both these outcomes are also limited by wide variation in the size and direction of effect across the studies.

Authors' conclusions: Mesh and non-mesh repairs are effective surgical approaches in treating hernias, each demonstrating benefits in different areas. Compared to non-mesh repairs, mesh repairs probably reduce the rate of hernia recurrence, and reduce visceral or neurovascular injuries, making mesh repair a common repair approach. Mesh repairs may result in a reduced length of hospital stay and time to return to activities of daily living, but these results are uncertain due to variation in the results of the studies. Non-mesh repair is less likely to cause seroma formation and has been favoured in low-income countries due to low cost and reduced availability of mesh materials. Risk of bias in the included studies was low to moderate and generally handled well by study authors, with attention to details of allocation, blinding, attrition and reporting.

Conflict of interest statement

None of the authors have any conflicts of interest to declare.

Figures

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Study flow diagram.
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Funnel plot of comparison: mesh vs non‐mesh repair, primary outcome: hernia recurrence.
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Funnel plot of comparison: mesh vs non‐mesh repair, primary outcome: complications.
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Risk of bias graph: review authors' judgements about each 'Risk of bias' item presented as percentages across all included studies.
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Risk of bias summary: review authors' judgements about each 'Risk of bias' item for each included study.
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Forest plot of comparison: 1 Comparison: Mesh vs Non‐Mesh repair, outcome: 1.1 Primary Outcome: Hernia Recurrence.
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Forest plot of comparison: 1 Comparison 1: Mesh vs Non‐Mesh repair, outcome: 1.2 Primary Outcome: Complications.
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Forest plot of comparison: 1 Outcomes, outcome: 1.10 Duration of surgery.
1.1. Analysis
1.1. Analysis
Comparison 1 Comparison: mesh versus non‐mesh repair, Outcome 1 Primary Outcome: Hernia Recurrence.
1.2. Analysis
1.2. Analysis
Comparison 1 Comparison: mesh versus non‐mesh repair, Outcome 2 Primary Outcome: Complications.
1.3. Analysis
1.3. Analysis
Comparison 1 Comparison: mesh versus non‐mesh repair, Outcome 3 Primary outcome: Mortality, 30 days post‐operation.
1.4. Analysis
1.4. Analysis
Comparison 1 Comparison: mesh versus non‐mesh repair, Outcome 4 Duration of surgical operation.
1.5. Analysis
1.5. Analysis
Comparison 1 Comparison: mesh versus non‐mesh repair, Outcome 5 Duration of Postoperative Stay.
1.6. Analysis
1.6. Analysis
Comparison 1 Comparison: mesh versus non‐mesh repair, Outcome 6 Time to return to full ADLs.

References

References to studies included in this review Abd El Maksoud 2014 {published data only}

    1. Abd El Maksoud W, Abd El Salam M, Ahmed HH. Comparative study between Lictenstein procedure and modified darn repair in treating primary inguinal hernia: a prospective randomised controlled trial. Hernia 2014;18(2):231‐6.
Barth 1998 {published data only}
    1. Barth RJ, Burchard KW, Tosteson A, Sutton JE, Colacchio TA. Short‐term outcome after mesh or Shouldice herniorrhaphy: A randomized, prospective study. Surgery 1998;123:121‐6.
Berndsen 2007 {published data only}
    1. Arvidsson D, Berndsen FH, Larsson LG, Leijonmarck CE, Rimback G, et al. Randomized clinical trial comparing 5‐year recurrence rate after laparoscopic versus Shouldice repair of primary inguinal hernia. British Journal of Surgery 2005;92:1085‐91.
    1. Berndsen FH, Petersson U, Arvidsson D, Leijonmarck CE, Rudberg C, Smedberg S, et al. Discomfort five years after laparoscopic and Shouldice inguinal hernia repair: a randomised trial with 867 patients. Hernia 2007;11:307‐13.
Butters 2007 {published data only}
    1. Butters M, Redecke J, Koninger J. Long‐term results of a randomised clinical trial of Shouldice, Lichtenstein and transabdominal preperitoneal hernia repairs. British Journal of Surgery 2007;94:562‐5.
    1. Koninger J, Redecke J, Butters M. Chronic pain after hernia repair: a randomised trial comparing Shouldice, Lichtenstein and TAPP. Langenbecks Archives of Surgery 2004;389:361‐5.
Chakraborty 2007 {published data only}
    1. Chakraborty S, Mukherjee A, Bhattacharya M. Tension‐free inguinal hernia repair comparing darn with mesh: a prospective randomised controlled clinical trial. Indian Journal of Surgery 2007;69(2):52‐6.
Elsebae 2008 {published data only}
    1. Elsebae M, Nasr M, Said M. Tension‐free repair versus Bassini technique for strangulated inguinal hernia: A controlled randomized study. International Journal of Surgery 2008;6:302‐5.
Hauters 1996 {published data only}
    1. Hauters Ph, Meunier D, Urgyan S, Jouret J, Janssen P, NYS JM. Controlled prospective study comparing laparoscopic and Shouldice in the treatment of unilateral inguinal hernia [Etude prospective controlee comparant laparoscopie et Shouldice dans le traitement de la hernie inguinale unilaterale]. Annales de Chirurgie 1996;50(9):776‐81.
Kaynak 2007 {published data only}
    1. Kaynak B, Celik F, Guner A, Guler K, Kaya M, Celik M. Moloney darn repair versus Lichtenstein mesh hernioplasty for open inguinal hernia repair. Surgery Today 2007;37:958–60.
Kucuk 2010 {published data only}
    1. Kucuk H, Sikar H, Kurt N, Uzun H, Eser M, Tutal F, et al. Lichtenstein or darn procedure in inguinal hernia repair: a prospective randomized comparative study. Hernia 2010;14:357–60.
Kux 1994 {published data only}
    1. Kux M, Fuchsjager N, Feichter A. Lichtenstein patch versus Shouldice technique in primary inguinal hernias with high recurrence risk. [Lichtenstein‐Patch versus Shouldice‐Technik bei primaren leistenhernien mit hoher rezidivgefahrdung]. Chirurg 1994;65:59‐62.
Leibl 1995 {published data only}
    1. Leibl B, Daubler P, Schwarz J, Ulrich M, Bittner R. Standardised laparoscopic hernia repair vs. Shouldice repair: results of a randomised comparative study [Standardisierte laparoskopische hernioplastik vs shouldice‐reparation: ergebnisse einer randomisierten vergleichsstudie]. Chirurg 1995;66:895‐8.
Lermite 2012 {published data only}
    1. Lermite E, Arnaud JP. Prospective randomized study comparing quality of life after Shouldice or mesh plug repair for inguinal hernia: short term results. Surgical Technology International XXII 2012;22:101‐6.
Manyilirah 2012 {published data only}
    1. Manyilirah W, Kijjambu S, Upoki A, Kiryabwire J. Comparison of non‐mesh (Desarda) and mesh (Lichtenstein) methods for inguinal hernia repair among black African patients: a short‐term double‐blind RCT. Hernia 2011;16:133–44.
McGillicuddy 1998 {published data only}
    1. McGillicuddy JE. Prospective randomized comparison of the Shouldice and Lichtenstein hernia repair procedures. Archieves of Surgery 1998;133:974‐8.
Nakagawa 2013 {published data only}
    1. Nakagawa M, Nagase T, Akatsu T, Imai S, Fujimura N, Asagoe T, et al. A randomized prospective trial comparing clinical outcomes 3 years after surgery by Marcy repair and Prolene Hernia System repair for adult indirect inguinal hernia. Surgery Today 2013;43:1109‐5.
Naveen 2014 {published data only}
    1. Naveen N, Srinath R. A comparative study between Modified Bassini's Repair and Lichtenstein Mesh Repair (LMR) of inguinal hernias in rural population. Journal of clinical and diagnostic research 2014;8(2):88‐91.
Nordin 2002 {published data only}
    1. Nordin P, Bartelmess P, Jansson C, Svensson C, Edlund G. Randomized trial of Lichtenstein versus Shouldice hernia repair in general surgical practice. British Journal of Surgery 2002;89:45‐9.
Panda 2012 {published data only}
    1. Panda N, Ghoshal P, Das S, Das R. Lichtenstein's mesh versus Bassini tissue repair technique for obstructed inguinal hernia: a controlled randomized study. European Surgery 2012;44:314‐8.
Prieto‐Diaz‐Chavez 2009 {published data only}
    1. Prieto‐Diaz‐Chavez E, Medina‐Chavez JL, Anaya‐Prado R. A cost‐effective analysis of tension‐free versus Shouldice inguinal hernia repair: a randomised double‐blind clinical trial. Hernia 2009;13:233‐8.
Prior 1998 {published data only}
    1. Prior MJ, Williams EV, Shukla HS, Phillips S, Vig S, Lewis M. Prospective randomized controlled trial comparing Lichtenstein with modified Bassini repair of inguinal hernia. Journal of the Royal College of Surgeons of Edinburgh 1998;43:82‐6.
Schmitz 1997 {published data only}
    1. Schmitz R, Treckmann J, Shah S, Schneider K. The tension free technique in open inguinal hernia repair: a prospective randomised study for post‐operative pain perception [Die „Tension‐free‐Technik“ bei offener Leistenhernienreparation: Eine prospektive, randomisierte Studie zur postoperativen Schmerzperception]. Chirurg 1997;68:259‐63.
Shi 2010 {published data only}
    1. Shi Y, Su Z, Li L, Liu H, Jing C. Comparing the effects of Bassini versus tension‐free hernioplasty: 3 years’ follow up. Frontiers of Medicine in China 2010;4(4):463‐8.
van Veen 2007 {published data only}
    1. Vrijland WW, Tol MP, Luijendik W, Hop WCJ, Busschbach JJV, Lange DCD, et al. Randomized clinical trial of non‐mesh versus mesh repair of primary inguinal hernia. British Journal of Surgery 2002;89:293‐7.
    1. Veen R, Wijsmuller A, Vrijland W, Hop W, Lange J, Jeekel J. Long‐term follow‐up of a randomised clinical trial of non‐mesh versus mesh repair of primary inguinal hernia. Surgery 2007;94:506‐10.
    1. Veen R, Wijsmuller A, Vrijland W, Hop W, Lange J, Jeekel J. Randomised clinical trial of mesh versus non‐mesh primary inguinal hernia repair: Long term chronic pain at 10 years. Surgery 2007;142:695‐8.
Witkowski 2000 {published data only}
    1. Witkowski P, Pirski MI, Adamonis W, Smietanksi M, Draczkowski T, Sledzinski Z. Mesh plug versus Bassini operation: a randomized prospective study. Hernia 2000;4:305‐10.
Zieren 1998 {published data only}
    1. Zieren J, Zieren H, Jacobi CA, Wenger FA, Muller JM. Prospective randomized study comparing laparoscopic and open tension‐free inguinal hernia repair with Shouldice’s operation. American Journal of Surgery 1998;175(4):330‐3.
References to studies excluded from this review Abu‐Own 2000 {published data only}
    1. Abu‐Own A, Onwudike M, Haque KA, Barker SG. Primary inguinal hernia repair utilizing the 'mesh plug' technique. Ambulatory Surgery 2000;8:31‐5.
Aigner 2014 {published data only}
    1. Aigner F, Augustin F, Kaufmann C, Schlager A, Ulmer H, et al. Prospective, randomized‐controlled trial comparing postoperative pain after plug and patch open repair with totally extraperitoneal inguinal hernia repair. Hernia 2014;18:237‐42.
Bay‐Nielsen 2004 {published data only}
    1. Bay‐Nielsen M, Nilsson E, Nordin P, Kehlet H. Chronic pain after open mesh and sutured repair of indirect inguinal hernia in young males. British Journal of Surgery 2003;91:1372‐6.
Chan 2008 {published data only}
    1. Chan G, Chan CK. Longterm results of a prospective study of 225 femoral hernia repairs: Indications for tissue and mesh repair. Journal of the American Collegel of Surgeons 2008;207:360‐7.
Suradom 2011 {published data only}
    1. Suradom C, Palaphun J. The usage of two umbrella made‐mesh plugs in herniorrhaphy: comparative study with Bassini and Lichtenstein method.. Journal of the Medical Association of Thailand (Chotmaihet thangphaet) 2011;94(11):1373‐9.
References to studies awaiting assessment Aigner 2011 {published data only}
    1. Aigner F, Augustin F, Kaufmann C, Schlager A, Ulmer H, Pratschke J, et al. Prospective, randomised‐controlled trial comparing postoperative pain after open and minimal invasive inguinal hernia repair (Abstract). European Surgery 2011;43:39.
Gedam 2017 {published data only}
    1. Gedam BS, Bansod PY, Kale VB, Shah Y, Akhtar M. A comparative study of Desarda's technique with Lichtenstein mesh repair in treatment of inguinal hernia: a prospective cohort study. International Journal of Surgery 2017;39:150‐155.
Memon 2017 {published data only}
    1. Memon GA, Shah SKA, Habib ur R. An experience with mesh versus darn repair in inguinal hernias. Pakistan Journal of Medical Sciences 2017;33:699‐702.
Additional references Amid 2005
    1. Amid PK. Groin hernia repair: open techniques. World Journal of Surgery 2005;28(8):1046‐51.
Atkins 2004
    1. Atkins D, Best D, Briss PA, Eccles M, Falck‐Ytter Y, Flottorp S, et al. GRADE Working Group. Grading quality of evidence and strength of recommendations. BMJ 2004;328(7454):1490.
Bittner 2011
    1. Bittner R, Arregui ME, Bisgaard T, Dudai M, Ferzli GS, Fitzgibbons RJ, et al. Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia [International Endohernia Society (IEHS)]. Journal of Endoscopic Surgery 2011;25(9):2773‐843.
Boonstra 2014
    1. Boonstra AM, Schiphorst Preuper HR, Balk GA, Stewart RE. Cut‐off points for mild, moderate, and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain. Pain 2014;155(12):2545‐50.
Brooks 2014a
    1. Brooks DC, Obeid A, Hawn M. Classification, clinical features and diagnosis of inguinal and femoral hernias in adults. Up To Date 2014.
Brooks 2014b
    1. Brooks DC. Overview of treatment for inguinal and femoral hernia in adults. Up To Date 2014.
Brooks 2014c
    1. Brooks DC. Overview of complications of inguinal and femoral hernia repair. Up To Date 2014.
Brown 2010
    1. Brown CN, Finch JG. Which mesh for hernia repair?. Annals of the Royal College of Surgeons, England 2010;92(4):272‐8.
Cannon 1981
    1. Cannon DJ, Read RC. Metastatic emphysema: a mechanism for acquiring inguinal herniation. Annals of Surgery 1981;194(3):270‐8.
Dahlstrand 2009
    1. Dahlstrand U, Wollert S, Nordin P, Sandblom G, Gunnarsson U. Emergency femoral hernia repair: a study based on a national register. Annals of Surgery 2009;249(4):672.
Doctor 2006
    1. Doctor HG. Evaluation of various prosthetic materials and newer meshes for hernia repairs. Journal of Minimal Access Surgery 2006;2(3):110‐6.
Eklund 2009
    1. Eklund AS, Montgomery AK, Rasmussen IC, Sandbue RP, Bergkvist LA, Rudberg CR. Low recurrence rate after laparoscopic (TEP) and open (Lichtenstein) inguinal hernia repair: a randomized, multicentre trial with 5‐year follow‐up. Annals of Surgery 2009;249(1):33‐8.
EU Hernia Trialists 2002
    1. The EU Hernia Trialists Collaboration. Repair of groin hernia with synthetic mesh: meta‐analysis of RCT. Annals of Surgery 2002;235:322‐32.
EU Hernia Trialists Collaboration 2000
    1. EU Hernia Trialists Collaboration 2000. Mesh compared with non‐mesh methods of open groin hernia repair: systematic review of randomized controlled trials. British Journal of Surgery 2000;87:854‐9.
EU Hernia Trialists Collaboration 2002
    1. EU Hernia Trialists Collaboration. Open mesh versus non‐mesh repair of groin hernia meta‐analysis of randomized trials leased on individual patient data. Hernia 2002;6:130‐6.
Falagas 2005
    1. Falagas ME, Kasiakou SK. Mesh‐related infections after hernia repair surgery. Clinical microbiology and infection 2005;11(1):3‐8.
Ferzli 1998
    1. Ferzli G, Sayad P, Huie F, Hallak A, Usal H. Endoscopic extraperitoneal herniorrhaphy. A 5‐year experience. Journal of Endoscopic Surgery 1998;12(11):1311.
Fitzgibbons 2006
    1. Fitzgibbons RJ Jr, Giobbie‐Hurder A, Gibbs JO, Dunlop DD, Reda DJ, et al. Watchful waiting vs repair of inguinal hernia in minimally symptomatic men: a randomized clinical trial. JAMA 2006;295(3):285.
Fitzgibbons 2015
    1. Fitzgibbons RJ, Forse RA. Groin hernias in adults. New England Journal of Medicine 2015;372:756‐63.
Gallegos 1991
    1. Gallegos NC, Dawson J, Jarvis M, Hobsley M. Risk of strangulation in groin hernias. British Journal of Surgery 1991;78(10):1171.
GRADEpro GDT 2014 [Computer program]
    1. GRADE Working Group. GRADEpro GDT. McMaster University, 2014.
Higgins 2011
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐.
Jenkins 2008
    1. Jenkins JT, O'Dwyer PJ. Inguinal hernias. BMJ 2008;336:269‐72.
Klinge 2002
    1. Klinge U, Klosterhalfen B, Birkenhauer V, Junge K, Conze J, Schumpelick V. Impact of polymer pore size on the interface scar formation in a rat model. Journal of the Surgical Resident 2002;103:208‐14.
Klinge 2008
    1. Klinge U. Mesh for hernia repair. British Journal of Surgery 2008;95:539‐40.
Koch 2005
    1. Koch A, Edwards A, Haapaniemi S, Nordin P, Kald A. Prospective evaluation of 6895 groin hernia repairs in women. British Journal of Surgery 2005;92(12):1553.
Liem 1997
    1. Liem MS, Graaf Y, Zwart RC, Geurts I, Vroonhoven TJ. Risk factors for inguinal hernia in women: a case‐control study. The Coala Trial Group. American Journal of Epidemiology 1997;146(9):721‐6.
Lofgren 2016
    1. Löfgren J, Nordin P, Ibingira C, Matovu A, Galiwango E, Wladis A. A randomized trial of low‐cost mesh in groin hernia repair. New England Journal of Medicine 2016;374:146‐53.
McCormack 2003
    1. McCormack K, Scott N, Go PM, Ross SJ, Grant A, Collaboration the EU Hernia Trialists. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database of Systematic Reviews 2003, Issue 1. [DOI: 10.1002/14651858.CD001785]
McKernan 1993
    1. McKernan JB, Laws H. Laparoscopic repair of inguinal hernias using a totally extraperitoneal prosthetic approach. Journal of Endoscopic Surgery 1993;7(1):26.
Nixon 2009
    1. Nixon SJ, Jawaid H. Recurrence after inguinal hernia repair at ten years by open darn, open mesh and TEP – no advantage with mesh. The Surgeon 2009;7:71‐4.
O'Dwyer 2005
    1. O'Dwyer, Kingsworth AN, Molloy RG, Small PK, Lammers B, Horeyseck G. Randomized clinical trial assessing impact of a lightweight or heavyweight mesh on chronic pain after inguinal hernia repair. British Journal of Surgery 2005;92:166‐70.
O'Dwyer 2006
    1. O'Dwyer PJ, Norrie J, Alani A, Walker A, Duffy F, Horgan P. Observation or operation for patients with an asymptomatic inguinal hernia: a randomized clinical trial. Annals of Surgery 2006;244(2):167.
Read 1999
    1. Read RC. Francis C. Usher, herniologist of the twentieth century. Hernia 1999;3(3):167‐71.
RevMan 2014 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Rosemar 2008
    1. Rosemar A, Angeras U, Rosengren A. Body mass index and groin hernia: a 34‐year follow‐up study in Swedish men. Annals of Surgery 2008;247(6):1064.
Rosemar 2010
    1. Rosemar A, Angeras U, Rosengren A, Nordin P. Effect of body mass index on groin hernia surgery. Annals of Surgery 2010;252(2):397‐401.
Rosenberg 2011
    1. Rosenberg J, Bisgaard T, Kehlet H, Wara P, Asmussen T, Juul P, et al. Danish Hernia Database recommendations for the management of inguinal and femoral hernia in adults. Danish Medical Bulletin 2011;58(2):42‐3.
Ruhl 2007
    1. Ruhl CE, Everhart JE. Risk factors for inguinal hernia among adults in the US population. American Journal of Epidemiology 2007;165(10):1154‐61.
Rutkow 1993
    1. Rutkow IM, Robbins AW. Demographic, classificatory, and socioeconomic aspects of hernia repair in the United States. Surgical Clinics of North America 1993;73(3):413.
Sajid 2013
    1. Sajid MS, Leaver C, Baig M, Sains P. Lightweight versus Heavyweight mesh for open repair of inguinal hernia. Cochrane Database of Systematic Reviews February 2013, Issue 2. [CENTRAL: 10.1002/14651858.CD009475]
Schünemann 2011
    1. Schünemann HJ, Oxman AD, Vist GE, Higgins JPT, Deeks JJ, Glasziou P, et al editor(s). Chapter 12: Interpreting results and drawing conclusions. In: Higgins JPT, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Intervention. Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from .
Simons 2009
    1. Simons MP, Aufenacker T, Bay‐Nielsen M, Bouillot JL, Campanelli G, Conze J, et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 2009;13(4):343‐403.
Skalad 1941
    1. Saklad M. Grading of patients for surgical procedures. Anesthesiology 1941;2:281‐4.
Sorenson 2002
    1. Sørensen LT, Friis E, Jørgensen T, Vennits B, Andersen BR, Rasmussen GI, et al. Smoking is a risk factor for recurrence of groin hernia. World Journal of Surgery 2002;26(4):397‐400.
Sterne 2011
    1. Sterne JAC, Egger M, Moher D, editor(s). Chapter 10: Addressing reporting biases. In: Higgins JPT, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Intervention. Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from .
Vader 1997
    1. Vader VL, Vogt DM, Zucker KA, Thilstead JP, Curet MJ. Adhesion formation in laparoscopic inguinal hernia repair. Journal of Endoscopic Surgery 1997;11(8):825.
Wake 2005
    1. Wake BL, McCormack K, Fraser C, Vale L, Perez J, Grant A. Transabdominal pre‐peritoneal (TAPP) vs totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair. Cochrane Database of Systematic Reviews 2005, Issue 1. [DOI: 10.1002/14651858.CD004703.pub2]
Whalen 2011
    1. Whalen HR, Kidd GA, O'Dwyer PJ. Femoral hernias. BMJ 2011;343:d7668.
WHO 2006
    1. World Health Organisation. BMI Classification. Global Database on Body Mass Index. 2006 (Last retrieved July 27, 2012).
Yang 2011
    1. Yang J, Papandria D, Rhee D, Perry H, Abdullah F. Low‐cost mesh for inguinal hernia repair in resource‐limited settings. Hernia 2011;15:485‐9.
References to other published versions of this review Scott 2001
    1. Scott N, Go PM, Graham P, McCormack K, Ross SJ, Grant AM. Open mesh versus non‐mesh for groin hernia repair. Cochrane Database of Systematic Reviews 2001, Issue 3. [DOI: 10.1002/14651858.CD002197]

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