Safety, feasibility and clinical outcome of minimally invasive inguinal hernia repair in patients with previous radical prostatectomy: A systematic review of the literature.

Groin hernia inguinal prostatectomy totally extraperitoneal transabdominal preperitoneal

Journal

Journal of minimal access surgery
ISSN: 0972-9941
Titre abrégé: J Minim Access Surg
Pays: India
ID NLM: 101228183

Informations de publication

Date de publication:
Historique:
pubmed: 13 11 2018
medline: 13 11 2018
entrez: 13 11 2018
Statut: ppublish

Résumé

Radical prostatectomy (RP) represents an important acquired risk factor for the development of primary inguinal hernias (IH) with an estimated incidence rates of 15.9% within the first 2 years after surgery. The prostatectomy-related preperitoneal fibrotic reaction can make the laparoendoscopic repair of the IH technically difficult, even if safety and feasibility have not been extensively evaluated yet. We conducted a systematic review of the available literature. A comprehensive computer literature search of PubMed and MEDLINE databases was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Terms used to search were ('laparoscopic' OR 'laparoscopy') AND ('inguinal' OR 'groin' OR 'hernia') AND 'prostatectomy'. The literature search from PubMed and MEDLINE databases revealed 156 articles. Five articles were considered eligible for the analysis, including 229 patients who underwent 277 hernia repairs. The pooled analysis indicates no statistically significant difference of post-operative complications (Risk Ratios [RR] 2.06; 95% confidence interval [CI] 0.85-4.97), conversion to open surgery (RR 3.91; 95% CI 0.85-18.04) and recurrence of hernia (RR 1.39; 95% CI 0.39-4.93) between the post-prostatectomy group and the control group. There was a statistically significant difference of minor intraoperative complications (RR 4.42; CI 1.05-18.64), due to an injury of the inferior epigastric vessels. Our systematic review suggests that, in experienced hands, safety, feasibility and clinical outcomes of minimally invasive repair of IH in patients previously treated with prostatectomy, are comparable to those patients without previous RP.

Sections du résumé

BACKGROUND BACKGROUND
Radical prostatectomy (RP) represents an important acquired risk factor for the development of primary inguinal hernias (IH) with an estimated incidence rates of 15.9% within the first 2 years after surgery. The prostatectomy-related preperitoneal fibrotic reaction can make the laparoendoscopic repair of the IH technically difficult, even if safety and feasibility have not been extensively evaluated yet. We conducted a systematic review of the available literature.
METHODS METHODS
A comprehensive computer literature search of PubMed and MEDLINE databases was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Terms used to search were ('laparoscopic' OR 'laparoscopy') AND ('inguinal' OR 'groin' OR 'hernia') AND 'prostatectomy'.
RESULTS RESULTS
The literature search from PubMed and MEDLINE databases revealed 156 articles. Five articles were considered eligible for the analysis, including 229 patients who underwent 277 hernia repairs. The pooled analysis indicates no statistically significant difference of post-operative complications (Risk Ratios [RR] 2.06; 95% confidence interval [CI] 0.85-4.97), conversion to open surgery (RR 3.91; 95% CI 0.85-18.04) and recurrence of hernia (RR 1.39; 95% CI 0.39-4.93) between the post-prostatectomy group and the control group. There was a statistically significant difference of minor intraoperative complications (RR 4.42; CI 1.05-18.64), due to an injury of the inferior epigastric vessels.
CONCLUSIONS CONCLUSIONS
Our systematic review suggests that, in experienced hands, safety, feasibility and clinical outcomes of minimally invasive repair of IH in patients previously treated with prostatectomy, are comparable to those patients without previous RP.

Identifiants

pubmed: 30416142
pii: 245149
doi: 10.4103/jmas.JMAS_218_18
pmc: PMC6839359
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

281-286

Déclaration de conflit d'intérêts

None

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Auteurs

Davide La Regina (D)

Department of Surgery, San Giovanni Hospital, Bellinzona, Switzerland.

Paolo Gaffuri (P)

Department of Surgery, San Giovanni Hospital, Bellinzona, Switzerland.

Marcello Ceppi (M)

Department of Clinical Epidemiology, Ospedale Policlinico San Martino, Genova, Italy.

Andrea Saporito (A)

Department of Anaesthesiology, San Giovanni Hospital, Bellinzona, Switzerland.

Matteo Ferrari (M)

Department of Urology, San Giovanni Hospital, Bellinzona, Switzerland.

Matteo Di Giuseppe (M)

Department of Surgery, San Giovanni Hospital, Bellinzona, Switzerland.

Francesco Mongelli (F)

Department of Surgery, San Giovanni Hospital, Bellinzona, Switzerland.

Classifications MeSH