Recurrence of Infection and Hernia Following Partial Versus Complete Removal of Infected Hernia Mesh: a Systematic Review and Cohort Meta-Analysis

Authors

M Gachabayov
S Gogna
Geena George, New York Medical CollegeFollow
David J. Samson, New York Medical CollegeFollow
R Latifi, New York Medical CollegeFollow

DOI

10.1007/s10029-019-02095-4

Journal Title

Hernia : the Journal of Hernias and Abdominal Wall Surgery

First Page

433

Last Page

439

Document Type

Article

Publication Date

6-1-2020

Department

Surgery

Abstract

BACKGROUND: The aim of this systematic review and meta-analysis was to determine whether complete removal of infected hernia mesh (CMR) provides better results as compared to partial removal (PMR).

METHODS: PubMed, EMBASE, Cochrane Library, and MEDLINE via Ovid were systematically searched for records published from 1980 to 2018 by three independent researchers (GM, GS, and GG). Quality assessment, data extraction and analysis were performed according to the Cochrane Handbook for Systematic Reviews of Interventions. Mantel-Haenszel method with odds ratio and 95% confidence interval (OR (95% CI)) as the measure of effect size of dichotomous primary and secondary endpoints was utilized. Random-effects model was used for meta-analysis.

RESULTS: Five observational studies totaling 421 patients were included in the meta-analysis. Rates of infection recurrence were 58.5% (62/106) in PMR and 25.5% (62/315) in CMR. The difference was statistically significant [OR (95% CI) 4.15 (2.30, 7.47); p < 0.001]. Rates of hernia recurrence were 9.7% (8/82) in PMR vs. 40.2% (41/102) in CMR. This difference was not statistically significant [OR (95% CI) 0.25 (0.04, 1.62); p = 0.15]. Low risk of publication bias was found using funnel plots and Egger's test.

CONCLUSIONS: This meta-analysis found significantly increased rates of infection recurrence in patients undergoing partial removal of infected hernia mesh as compared to complete removal. Complete removal of infected hernia mesh may be associated with increased rates of hernia recurrence. Further longitudinal observational studies are needed to confirm these findings.

Recommended Citation

Gachabayov, M., Gogna, S., George, G., Samson, D. J., & Latifi, R. (2020). Recurrence of Infection and Hernia Following Partial Versus Complete Removal of Infected Hernia Mesh: a Systematic Review and Cohort Meta-Analysis. Hernia : the Journal of Hernias and Abdominal Wall Surgery, 24 (3), 433-439. https://doi.org/10.1007/s10029-019-02095-4