Jahanzaib Saeed
1.1_Introduction
The Desarda technique is a non-mesh tissue-based method for inguinal hernia repair introduced in 2001. While the Lichtenstein mesh repair remains the gold standard but concerns about mesh-related complications have renewed interest in non-mesh alternatives. This systematic review and meta-analysis, compares postoperative complications between the Desarda and Lichtenstein techniques.
1.2_Methods
We searched the Pubmed, Cochrane, Embase, Emcare, Medline and Ovid for studies published until 1st December 2024. We used the fixed effect model to pool the studies after assessing the heterogenicity by rob2 version 2019. We performed the statistical analysis using Revman 5.4 version.
1.3_Results
A total number of twenty-three RCTs were included in the studies, comprising of 2425 patients of whom 1201 were undergone desardarepair and 1233 were undergone Lichtenstein mesh repair. The desarda technique was associated with lower rate of scrotal edema (CI=0.34,0.78) (RR=0.52) (P=0.002), seroma (CI=0.47,0.99) (RR=0.68) (P=0.04), foreign body sensation (CI=0.42,0.88) (RR=0.61) (P=0.009) and chronic pain (CI=0.15,0.45) (RR=0.26) (P=0.00001). Although there is lower rate of recurrence, wound infection, wound hematoma and loss of sensation in desarda technique but it is not statistically reliable.
1.4_Conclusion
The Desarda technique is associated with significantly fewer postoperative complications particularly scrotal edema, seroma, foreign body sensation and chronic pain as compared to the Lichtenstein mesh repair. These findings support Desarda as a viable non-mesh alternative in suitable patients.
Authors
Jahanzaib Saeed
Shrewsbury and Telford NHS Foundation Trust, Shrewsbury, United Kingdom