Researchers from medical institutions in Missouri, USA, and Chiba-ken, Japan, have conducted a meta-analysis to determine the degree to which improvements in open hernia repair (OHR) in the last 10 years have altered the relative benefits of laparoscopic hernia repair (LHR).
Writing in The American Journal of Surgery, Dr C. Randle Voyles and colleagues evaluated 27 comparative trials including 4,688 randomized patients.
They found that within the control OHR, patients with routine mesh repair returned to work earlier than a sutured repair (16.4 days versus 27.3 days).
During the study period, the increased use of mesh in OHR (3 of 12 initially versus 9 of 15 subsequent studies) was associated with an earlier return to work (25.9 to 16.8 days).
There was no significant improvement with corresponding LHR.
The research group concludes that although LHR was associated with an earlier return to work compared with conventional sutured OHR, more recent mesh OHRs provide equivalent costs.
These outcomes are at lower costs and are associated with potentially less severe complications, supporting an open technique using preperitoneal mesh prostheses as the optimal hernia repair.