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Peer-reviewed veterinary case report

Mesh versus no-mesh repair for femoral hernia surgery outcomes

By Abdalgany A et al.·2025·General Surgery·View original on Europe PMC

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Original publication title: Mesh Repair Versus No-Mesh Repair for the Management of Acute and Elective Femoral Hernias: A Systematic Review and Meta-Analysis of Perioperative Outcomes.

Plain-English summary

This study looked at whether using mesh to repair femoral hernias (a type of hernia in the groin area) is better than not using mesh. Researchers analyzed data from several studies involving 537 patients to see how often hernias came back, if there were infections, complications, and how long patients stayed in the hospital. They found that while patients who had mesh repairs tended to stay in the hospital for a shorter time, there wasn't a clear advantage in terms of hernia recurrence or complications when compared to those who had no mesh. Overall, the findings suggest that using mesh doesn't significantly improve outcomes over no mesh, and more research is needed to confirm these results.

Abstract

The objective of this meta-analysis was to compare mesh repair versus no-mesh repair in the management of acute and elective femoral hernia repair. Different studies comparing mesh repair versus no-mesh repair in the management of femoral hernia were selected from medical electronic databases, and a meta-analysis was conducted in accordance with the Cochrane Collaboration guidelines using statistical software RevMan version 5.4 (The Cochrane Collaboration, London, UK). Four retrospective studies and one prospective study were included, involving 537 patients, reporting the incidence of recurrence, surgical site infection, complications, and length of hospital stay. In the random effects model analysis, the length of hospital stay was lower in the mesh group but with significant statistical heterogeneity (standardized mean difference (SMD) -0.34, 95% CI (-1.78, -1.11), Z = 0.46, P = 0.65). However, the variables of hernia recurrence, surgical site infection, and total complications were in favor of the mesh group, despite no statistically significant difference between both groups and without any statistical heterogeneity among the included studies: (risk ratio (RR) 0.50, 95% CI (0.25, 1.02), Z = 1.91, P = 0.06); (RR 0.95, 95% CI (0.35, 2.57), Z = 0.10, P = 0.92); (RR 0.99, 95% CI (0.56, 1.74), Z = 0.05, P = 0.96). This systematic review indicates that mesh repair of the femoral hernia does not offer any advantage over no-mesh repair for recurrence. Due to the paucity of randomized clinical trials and significant heterogeneity among the compared variables, a major multicenter randomized clinical trial is needed to validate these findings.

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Original publication on Europe PMC: https://europepmc.org/article/MED/41394233