Long-Term Efficacy of Lightweight Meshes Versus Heavyweight Meshes in Lichtenstein Repair for Inguinal Hernias: A Meta-Analysis

Objective The aim of this study was to assess the long-term clinical efficacy and safety of lightweight meshes and heavyweight meshes in the Lichtenstein repair for inguinal hernias. Methods Such databases as PubMed, EMBASE, Web of Science, The Cochrane Library, CBM, CNKI, WanFang Data and VIP were electronically searched for relevant studies from inception to November, 2013.References of the included studies were also retrieved.Two reviewers independently screened literature according to the inclusion and exclusion criteria as well as the Methods recommended by the Cochrane Collaboration, extracted data, and assessed the methodological quality of the included studies.Then, meta-analysis was performed using RevMan 5.2.5 software.Results 15 RCTs involving 3 390 patients were included.The results of meta-analysis showed that: Compared with heavyweight meshes, lightweight meshes was associated with a lesser incidence of chronic pain during the short-term （≤ 12 months） postoperative period （6 months: RR=.67, 95%CI 0.53 to 0.83, P=0.000 3; 12 months: RR=0.79, 95%CI 0.64 to 0.98, P=0.03）, sensation of a foreign body（RR=0.69, 95%CI 0.56 to 0.85, P=0.000 5）.However, there was no statistically significant difference in the incidence of chronic pain during the long-term （> 12 months） postoperative period（RR=0.93, 95%CI 0.72 to 1.19, P=0.56）, recurrence（RR=1.21, 95%CI 0.77 to 1.90, P=0.41） and testicular atrophy（RR=1.90, 95%CI 0.58 to 6.28, P=0.29）. Conclusion Current evidence suggests that the use of lightweight meshes is associated with less short-term postoperative pain and less sensation of a foreign body, without increasing the incidence of recurrence.The lightweight mesh can be used as the preferred for the hernioplasty procedure.