Comparison of mesh fixation techniques in laparoscopic trans-abdominal preperitoneal hernia repair: a network meta-analysis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

JIANG Weirong ¹ ,  MENG Yong ^1,2 , GAO Mingqing ² , YU Yongjiang ^3,4 , LI Rui ¹ , CHEN Wenhao ¹ , XU Zhen ¹

1. The Fourth Department of General Surgery, Xi’an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi’an 710018, P. R. China;
2. Northwest University School of Medicine, Xi’an 710069, P. R. China;
3. Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou 730030, P. R. China;
4. The First School of Clinical Medicine of Lanzhou University, Lanzhou 730030, P. R. China;

Corresponding author：

MENG Yong, Email: my176@126.com

Keywords：

inguinal hernia; trans-abdominal preperitoneal hernia repair; mesh fixation; postoperative complication; network meta-analysis

DOI：

10.7507/1007-9424.202208086

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Objective To evaluate the clinical effectiveness and safety of different mesh fixation techniques in laparoscopic trans-abdominal preperitoneal hernia repair (TAPP) by using network meta-analysis. Methods CNKI, WanFang Data, VIP, CBM, the Cochrane Library, PubMed, Embase, and Web of Science databases were retrieved to collect randomized controlled trials (RCTs) studies comparing different fixation methods of patches in laparoscopic TAPP. The retrieval time limit was from the establishment of the database to March 1, 2022. After two researchers independently screened the literatures, extracted the data, and evaluated the bias risk, Bayesian network meta-analysis was conducted by using R4.1.2 software. Results Twenty-nine RCTs were included, including 4 095 patients. The results of network meta-analysis showed that the risk of chronic postoperative inguinal pain was higher in staples fixation than that of no fixation [OR=0.06, 95%CI (0.01, 0.26), P＜0.001], glue fixation [OR=0.21, 95%CI (0.04, 0.53), P=0.001] and self-gripping mesh [OR=0.09, 95%CI (0.01, 0.52), P=0.009], the incidence of chronic postoperative inguinal pain with suture fixation was higher than that with no fixation [OR=0.10, 95%CI (0.01, 0.70), P= 0.020]. Postoperative visual analogue scale of staples fixation was higher than those of no fixation [MD=–0.90, 95%CI (–1.49, –0.33), P=0.002] and glue fixation [MD=–0.92, 95%CI (–1.35, –0.49), P＜0.001], the postoperative visual analogue scale with suture fixation was higher than those of no fixation [MD=–0.83, 95%CI (–1.61, –0.08), P=0.030] and glue fixation [MD=–0.85, 95%CI (–1.56, –0.13), P=0.020]. There was no significant difference in the incidence of seroma and hematoma, hospital stay and hernia recurrence among different fixation methods. Conclusions The network meta-analysis shows that medical glue and self-gripping mesh have certain advantages in reducing chronic pain after surgery, which may be the better patch fixation method in TAPP. The non fixation mesh will not increase the risk of postoperative recurrence, and can be used in clinical practice. This conclusion needs to be further verified by large sample, long-term follow-up and high-quality RCTs.

Citation： JIANG Weirong, MENG Yong, GAO Mingqing, YU Yongjiang, LI Rui, CHEN Wenhao, XU Zhen. Comparison of mesh fixation techniques in laparoscopic trans-abdominal preperitoneal hernia repair: a network meta-analysis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(2): 204-213. doi: 10.7507/1007-9424.202208086 Copy

1.	The HerniaSurge Group. International guidelines for groin hernia management. Hernia, 2018, 22(1): 1-165.
2.	宁彩虹, 黄耿文, 林嘉晏, 等. 腹腔镜经腹腹膜前疝修补日间手术的临床价值分析. 中国普通外科杂志, 2021, 30(4): 399-405.
3.	Aiolfi A, Cavalli M, Del Ferraro S, et al. Total extraperitoneal (TEP) versus laparoscopic transabdominal preperitoneal (TAPP) hernioplasty: systematic review and trial sequential analysis of randomized controlled trials. Hernia, 2021, 25(5): 1147-1157.
4.	于志远, 杨诗语, 柳博文, 等. 腹腔镜经腹膜前腹股沟疝修补术后慢性疼痛的风险预测模型. 中国普外基础与临床杂志, 2022, 29(6): 761-767.
5.	Arregui ME, Navarrete J, Davis CJ, et al. Laparoscopic inguinal herniorrhaphy. Techniques and controversies. Surg Clin North Am, 1993, 73(3): 513-527.
6.	李瑞斌, 吴攀, 万智恒. 经腹腹膜前腹腔镜腹股沟疝修补术在腹股沟疝无张力修补中的应用. 中国普通外科杂志, 2020, 29(10): 1275-1279.
7.	孙斌杰, 李云锋, 余坤, 等. 腹股沟疝术后慢性疼痛的诊疗进展. 国际外科学杂志, 2021, 48(7): 493-499.
8.	Cumpston M, Li T, Page MJ, et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev, 2019, 10: Ed000142. doi: 10.1002/14651858.ED000142.
9.	Ahmed M, Kumar V, Akram M, et al. Post-operative pain and early complications in patients undergoing laparoscopic transabdominal preperitoneal inguinal hernia repair using mesh fixation with sutures versus tackers. P J M H S, 2021, 15(1): 537-539.
10.	Boldo E, Armelles A, Perez de Lucia G, et al. Pain after laparascopic bilateral hernioplasty: early results of a prospective randomized double-blind study comparing fibrin versus staples. Surg Endosc, 2008, 22(5): 1206-1209.
11.	Bruegger L, Bloesch M, Ipaktchi R, et al. Objective hypoesthesia and pain after transabdominal preperitoneal hernioplasty: a prospective, randomized study comparing tissue adhesive versus spiral tacks. Surg Endosc, 2012, 26(4): 1079-1085.
12.	Cambal M, Zonca P, Hrbaty B. Comparison of self-gripping mesh with mesh fixation with fibrin-glue in laparoscopic hernia repair (TAPP). Bratisl Lek Listy, 2012, 113(2): 103-107.
13.	Ferrarese A, Bindi M, Rivelli M, et al. Self-gripping mesh versus fibrin glue fixation in laparoscopic inguinal hernia repair: a randomized prospective clinical trial in young and elderly patients. Open Med (Wars), 2016, 11(1): 497-508.
14.	Ferzli GS, Eldo Frezza E, Pecoraro AM Jr, et al. Prospective randomized study of stapled versus unstapled mesh in a laparoscopic preperitoneal inguinal hernia repair. J Am Coll Surg, 1999, 188(5): 461-465.
15.	Fortelny RH, Petter-Puchner AH, May C, et al. The impact of atraumatic fibrin sealant vs. staple mesh fixation in TAPP hernia repair on chronic pain and quality of life:results of a randomized controlled study. Surg Endosc, 2012, 26(1): 249-254.
16.	Fumagalli Romario U, Puccetti F, Elmore U, et al. Self-gripping mesh versus staple fixation in laparoscopic inguinal hernia repair: a prospective comparison. Surg Endosc, 2013, 27(5): 1798-1802.
17.	Habeeb TAAM, Mokhtar MM, Sieda B, et al. Changing the innate consensus about mesh fixation in trans-abdominal preperitoneal laparoscopic inguinal hernioplasty in adults: short and long term outcome. Randomized controlled clinical trial. Int J Surg, 2020, 83: 117-124.
18.	Ielpo B, Nuñez J, Ferri V, et al. Laparoscopic inguinal hernia repair: cost-effectiveness analysis of trend modifications of the technique. Updates Surg, 2021, 73(5): 1945-1953.
19.	Kalidarei B, Mahmoodieh M, Sharbu Z. Comparison of mesh fixation and nonfixation in laparoscopic transabdominal preperitoneal repair of inguinal hernia. Formos J Surg, 2019, 52(6): 212-220.
20.	Khalil AA, Ebeid EF, Ismail AI. Comparative study between the use of self-fixating mesh and non-self-fixating mesh in laparoscopic inguinal hernia repair transabdominal preperitoneal technique. Egyp J Surg, 2019, 38(3): 588-596.
21.	Leibl BJ, Kraft B, Redecke JD, et al. Are postoperative complaints and complications influenced by different techniques in fashioning and fixing the mesh in transperitoneal laparoscopic hernioplasty? Results of a prospective randomized trial. World J Surg, 2002, 26(12): 1481-1484.
22.	Li W, Sun D, Sun Y, et al. The effect of transabdominal preperitoneal (TAPP) inguinal hernioplasty on chronic pain and quality of life of patients: mesh fixation versus non-fixation. Surg Endosc, 2017, 31(10): 4238-4243.
23.	Lovisetto F, Zonta S, Rota E, et al. Use of human fibrin glue (Tissucol) versus staples for mesh fixation in laparoscopic transabdominal preperitoneal hernioplasty: a prospective, randomized study. Ann Surg, 2007, 245(2): 222-231.
24.	Olmi S, Scaini A, Erba L, et al. Quantification of pain in laparoscopic transabdominal preperitoneal (TAPP) inguinal hernioplasty identifies marked differences between prosthesis fixation systems. Surgery, 2007, 142(1): 40-46.
25.	Qureshi S, Ghazanfar S, Leghari AA, et al. A comparative follow up study of transabdominal preperitoneal mesh repair in inguinal hernias with or without mesh fixation. J Pak Med Assoc, 2021, 71(1A): 28-30.
26.	Smith AI, Royston CM, Sedman PC. Stapled and nonstapled laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. A prospective randomized trial. Surg Endosc, 1999, 13(8): 804-806.
27.	Tarasenko SV, Bogomolov AY, Natal’skiy AA, et al. Laparoscopic inguinal hernia repair without fixation. Kazan Med J , 2018, 99(4): 712-716.
28.	Tolver MA, Rosenberg J, Juul P, et al. Randomized clinical trial of fibrin glue versus tacked fixation in laparoscopic groin hernia repair. Surg Endosc, 2013, 27(8): 2727-2733.
29.	Torre F, Madureira F, Hernández M. Comparison of postoperative pain in laparoscopic inguinal hernia repairs by the transabdominal preperitoneal technique with self-gripping mesh versus tacker fixation. Int J Abdom Wall Hernia Surg, 2020, 3(2): 45-49.
30.	Wang L, Jin X, Wang H, et al. Laparoscopic transabdominal preperitoneal procedure with and without mesh-fixation for inguinal hernia repairs. Int J Clin Exp Med, 2018, 11(8): 8651-8655.
31.	Zayed ME, Essa MS. Impact of mesh fixation vs non-fixation in laparoscopic transabdominal preperitoneal inguinal hernia repair on chronic groin pain and quality of life: a prospective randomized study. Egyp J Surg, 2020, 39(3): 574-581.
32.	冯阳, 李广阔, 李力, 等. 自固定网片与聚丙烯平片用于成人TAPP的效果比较研究. 西南国防医药, 2015, 25(4): 399-402.
33.	郭春海, 吴永哲, 魏金平, 等. 腹腔镜经腹腹膜前疝修补术中各种补片固定方法的疗效观察. 中华疝和腹壁外科杂志(电子版), 2020, 14(1): 47-50.
34.	黄国增, 陈荫曾, 李旺, 等. 免钉合器腹腔镜下经腹腔腹膜前法腹股沟疝修补术的临床研究. 实用医学杂志, 2017, 33(13): 2180-2183.
35.	王明刚, 陈杰, 申英末, 等. 腹腔镜腹股沟疝修补术中疝固定器与医用胶固定补片的疗效研究. 北京医学, 2010, 32(7): 528-530.
36.	吴国斌, 苏玉国, 王炬, 等. 腹腔镜腹股沟疝修补术中疝固定器与医用胶固定补片的疗效比较研究. 现代中西医结合杂志, 2017, 26(25): 2789-2791.
37.	张志勇. 腹腔镜腹股沟疝修补术两种补片固定方法的前瞻性对比研究. 腹腔镜外科杂志, 2006, 11(3): 210-211.
38.	Beel E, Berrevoet F. Surgical treatment for chronic pain after inguinal hernia repair: a systematic literature review. Langenbecks Arch Surg, 2022, 407(2): 541-548.
39.	Takayama Y, Kaneoka Y, Maeda A, et al. Short- and long-term outcomes of transabdominal preperitoneal, open mesh plug and open tissue inguinal hernia repair. World J Surg, 2021, 45(3): 730-737.
40.	安丽娟, 俞永江. 腹股沟疝修补术后慢性腹股沟疼痛危险因素的研究进展. 中国普外基础与临床杂志, 2020, 27(5): 629-633.
41.	Techapongsatorn S, Tansawet A, Kasetsermwiriya W, et al. Mesh fixation technique in totally extraperitoneal inguinal hernia repair—A network meta-analysis. Surgeon, 2019, 17(4): 215-224.
42.	Kaul A, Hutfless S, Le H, et al. Staple versus fibrin glue fixation in laparoscopic total extraperitoneal repair of inguinal hernia: a systematic review and meta-analysis. Surg Endosc, 2012, 26(5): 1269-1278.
43.	Reinpold W, Schroeder AD, Schroeder M, et al. Retroperitoneal anatomy of the iliohypogastric, ilioinguinal, genitofemoral, and lateral femoral cutaneous nerve: consequences for prevention and treatment of chronic inguinodynia. Hernia, 2015, 19(4): 539-548.
44.	Forester B, Attaar M, Chirayil S, et al. Predictors of chronic pain after laparoscopic inguinal hernia repair. Surgery, 2021, 169(3): 586-594.
45.	Bjurström MF, Irwin MR, Chen DC, et al. Sex differences, sleep disturbance and risk of persistent pain associated with groin hernia surgery: a nationwide register-based cohort study. J Pain, 2021, 22(11): 1360-1370.
46.	Romain B, Fabacher T, Ortega-Deballon P, et al. Longitudinal cohort study on preoperative pain as a risk factor for chronic postoperative inguinal pain after groin hernia repair at 2-year follow-up. Hernia, 2022, 26(1): 189-200.
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50.	Buyukasik K, Ari A, Akce B, et al. Comparison of mesh fixation and non-fixation in laparoscopic totally extraperitoneal inguinal hernia repair. Hernia. 2017, 21(4): 543-548.
51.	Sahebally SM, Horan J, Rogers AC, et al. Fixation versus no fixation in laparoscopic totally extraperitoneal repair of primary inguinal hernia—a systematic review and meta-analysis of randomized controlled trials. Langenbecks Arch Surg, 2020, 405(4): 435-443.
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1. The HerniaSurge Group. International guidelines for groin hernia management. Hernia, 2018, 22(1): 1-165.
2. 宁彩虹, 黄耿文, 林嘉晏, 等. 腹腔镜经腹腹膜前疝修补日间手术的临床价值分析. 中国普通外科杂志, 2021, 30(4): 399-405.
3. Aiolfi A, Cavalli M, Del Ferraro S, et al. Total extraperitoneal (TEP) versus laparoscopic transabdominal preperitoneal (TAPP) hernioplasty: systematic review and trial sequential analysis of randomized controlled trials. Hernia, 2021, 25(5): 1147-1157.
4. 于志远, 杨诗语, 柳博文, 等. 腹腔镜经腹膜前腹股沟疝修补术后慢性疼痛的风险预测模型. 中国普外基础与临床杂志, 2022, 29(6): 761-767.
5. Arregui ME, Navarrete J, Davis CJ, et al. Laparoscopic inguinal herniorrhaphy. Techniques and controversies. Surg Clin North Am, 1993, 73(3): 513-527.
6. 李瑞斌, 吴攀, 万智恒. 经腹腹膜前腹腔镜腹股沟疝修补术在腹股沟疝无张力修补中的应用. 中国普通外科杂志, 2020, 29(10): 1275-1279.
7. 孙斌杰, 李云锋, 余坤, 等. 腹股沟疝术后慢性疼痛的诊疗进展. 国际外科学杂志, 2021, 48(7): 493-499.
8. Cumpston M, Li T, Page MJ, et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev, 2019, 10: Ed000142. doi: 10.1002/14651858.ED000142.
9. Ahmed M, Kumar V, Akram M, et al. Post-operative pain and early complications in patients undergoing laparoscopic transabdominal preperitoneal inguinal hernia repair using mesh fixation with sutures versus tackers. P J M H S, 2021, 15(1): 537-539.
10. Boldo E, Armelles A, Perez de Lucia G, et al. Pain after laparascopic bilateral hernioplasty: early results of a prospective randomized double-blind study comparing fibrin versus staples. Surg Endosc, 2008, 22(5): 1206-1209.
11. Bruegger L, Bloesch M, Ipaktchi R, et al. Objective hypoesthesia and pain after transabdominal preperitoneal hernioplasty: a prospective, randomized study comparing tissue adhesive versus spiral tacks. Surg Endosc, 2012, 26(4): 1079-1085.
12. Cambal M, Zonca P, Hrbaty B. Comparison of self-gripping mesh with mesh fixation with fibrin-glue in laparoscopic hernia repair (TAPP). Bratisl Lek Listy, 2012, 113(2): 103-107.
13. Ferrarese A, Bindi M, Rivelli M, et al. Self-gripping mesh versus fibrin glue fixation in laparoscopic inguinal hernia repair: a randomized prospective clinical trial in young and elderly patients. Open Med (Wars), 2016, 11(1): 497-508.
14. Ferzli GS, Eldo Frezza E, Pecoraro AM Jr, et al. Prospective randomized study of stapled versus unstapled mesh in a laparoscopic preperitoneal inguinal hernia repair. J Am Coll Surg, 1999, 188(5): 461-465.
15. Fortelny RH, Petter-Puchner AH, May C, et al. The impact of atraumatic fibrin sealant vs. staple mesh fixation in TAPP hernia repair on chronic pain and quality of life:results of a randomized controlled study. Surg Endosc, 2012, 26(1): 249-254.
16. Fumagalli Romario U, Puccetti F, Elmore U, et al. Self-gripping mesh versus staple fixation in laparoscopic inguinal hernia repair: a prospective comparison. Surg Endosc, 2013, 27(5): 1798-1802.
17. Habeeb TAAM, Mokhtar MM, Sieda B, et al. Changing the innate consensus about mesh fixation in trans-abdominal preperitoneal laparoscopic inguinal hernioplasty in adults: short and long term outcome. Randomized controlled clinical trial. Int J Surg, 2020, 83: 117-124.
18. Ielpo B, Nuñez J, Ferri V, et al. Laparoscopic inguinal hernia repair: cost-effectiveness analysis of trend modifications of the technique. Updates Surg, 2021, 73(5): 1945-1953.
19. Kalidarei B, Mahmoodieh M, Sharbu Z. Comparison of mesh fixation and nonfixation in laparoscopic transabdominal preperitoneal repair of inguinal hernia. Formos J Surg, 2019, 52(6): 212-220.
20. Khalil AA, Ebeid EF, Ismail AI. Comparative study between the use of self-fixating mesh and non-self-fixating mesh in laparoscopic inguinal hernia repair transabdominal preperitoneal technique. Egyp J Surg, 2019, 38(3): 588-596.
21. Leibl BJ, Kraft B, Redecke JD, et al. Are postoperative complaints and complications influenced by different techniques in fashioning and fixing the mesh in transperitoneal laparoscopic hernioplasty? Results of a prospective randomized trial. World J Surg, 2002, 26(12): 1481-1484.
22. Li W, Sun D, Sun Y, et al. The effect of transabdominal preperitoneal (TAPP) inguinal hernioplasty on chronic pain and quality of life of patients: mesh fixation versus non-fixation. Surg Endosc, 2017, 31(10): 4238-4243.
23. Lovisetto F, Zonta S, Rota E, et al. Use of human fibrin glue (Tissucol) versus staples for mesh fixation in laparoscopic transabdominal preperitoneal hernioplasty: a prospective, randomized study. Ann Surg, 2007, 245(2): 222-231.
24. Olmi S, Scaini A, Erba L, et al. Quantification of pain in laparoscopic transabdominal preperitoneal (TAPP) inguinal hernioplasty identifies marked differences between prosthesis fixation systems. Surgery, 2007, 142(1): 40-46.
25. Qureshi S, Ghazanfar S, Leghari AA, et al. A comparative follow up study of transabdominal preperitoneal mesh repair in inguinal hernias with or without mesh fixation. J Pak Med Assoc, 2021, 71(1A): 28-30.
26. Smith AI, Royston CM, Sedman PC. Stapled and nonstapled laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. A prospective randomized trial. Surg Endosc, 1999, 13(8): 804-806.
27. Tarasenko SV, Bogomolov AY, Natal’skiy AA, et al. Laparoscopic inguinal hernia repair without fixation. Kazan Med J , 2018, 99(4): 712-716.
28. Tolver MA, Rosenberg J, Juul P, et al. Randomized clinical trial of fibrin glue versus tacked fixation in laparoscopic groin hernia repair. Surg Endosc, 2013, 27(8): 2727-2733.
29. Torre F, Madureira F, Hernández M. Comparison of postoperative pain in laparoscopic inguinal hernia repairs by the transabdominal preperitoneal technique with self-gripping mesh versus tacker fixation. Int J Abdom Wall Hernia Surg, 2020, 3(2): 45-49.
30. Wang L, Jin X, Wang H, et al. Laparoscopic transabdominal preperitoneal procedure with and without mesh-fixation for inguinal hernia repairs. Int J Clin Exp Med, 2018, 11(8): 8651-8655.
31. Zayed ME, Essa MS. Impact of mesh fixation vs non-fixation in laparoscopic transabdominal preperitoneal inguinal hernia repair on chronic groin pain and quality of life: a prospective randomized study. Egyp J Surg, 2020, 39(3): 574-581.
32. 冯阳, 李广阔, 李力, 等. 自固定网片与聚丙烯平片用于成人TAPP的效果比较研究. 西南国防医药, 2015, 25(4): 399-402.
33. 郭春海, 吴永哲, 魏金平, 等. 腹腔镜经腹腹膜前疝修补术中各种补片固定方法的疗效观察. 中华疝和腹壁外科杂志(电子版), 2020, 14(1): 47-50.
34. 黄国增, 陈荫曾, 李旺, 等. 免钉合器腹腔镜下经腹腔腹膜前法腹股沟疝修补术的临床研究. 实用医学杂志, 2017, 33(13): 2180-2183.
35. 王明刚, 陈杰, 申英末, 等. 腹腔镜腹股沟疝修补术中疝固定器与医用胶固定补片的疗效研究. 北京医学, 2010, 32(7): 528-530.
36. 吴国斌, 苏玉国, 王炬, 等. 腹腔镜腹股沟疝修补术中疝固定器与医用胶固定补片的疗效比较研究. 现代中西医结合杂志, 2017, 26(25): 2789-2791.
37. 张志勇. 腹腔镜腹股沟疝修补术两种补片固定方法的前瞻性对比研究. 腹腔镜外科杂志, 2006, 11(3): 210-211.
38. Beel E, Berrevoet F. Surgical treatment for chronic pain after inguinal hernia repair: a systematic literature review. Langenbecks Arch Surg, 2022, 407(2): 541-548.
39. Takayama Y, Kaneoka Y, Maeda A, et al. Short- and long-term outcomes of transabdominal preperitoneal, open mesh plug and open tissue inguinal hernia repair. World J Surg, 2021, 45(3): 730-737.
40. 安丽娟, 俞永江. 腹股沟疝修补术后慢性腹股沟疼痛危险因素的研究进展. 中国普外基础与临床杂志, 2020, 27(5): 629-633.
41. Techapongsatorn S, Tansawet A, Kasetsermwiriya W, et al. Mesh fixation technique in totally extraperitoneal inguinal hernia repair—A network meta-analysis. Surgeon, 2019, 17(4): 215-224.
42. Kaul A, Hutfless S, Le H, et al. Staple versus fibrin glue fixation in laparoscopic total extraperitoneal repair of inguinal hernia: a systematic review and meta-analysis. Surg Endosc, 2012, 26(5): 1269-1278.
43. Reinpold W, Schroeder AD, Schroeder M, et al. Retroperitoneal anatomy of the iliohypogastric, ilioinguinal, genitofemoral, and lateral femoral cutaneous nerve: consequences for prevention and treatment of chronic inguinodynia. Hernia, 2015, 19(4): 539-548.
44. Forester B, Attaar M, Chirayil S, et al. Predictors of chronic pain after laparoscopic inguinal hernia repair. Surgery, 2021, 169(3): 586-594.
45. Bjurström MF, Irwin MR, Chen DC, et al. Sex differences, sleep disturbance and risk of persistent pain associated with groin hernia surgery: a nationwide register-based cohort study. J Pain, 2021, 22(11): 1360-1370.
46. Romain B, Fabacher T, Ortega-Deballon P, et al. Longitudinal cohort study on preoperative pain as a risk factor for chronic postoperative inguinal pain after groin hernia repair at 2-year follow-up. Hernia, 2022, 26(1): 189-200.
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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Comparison of mesh fixation techniques in laparoscopic trans-abdominal preperitoneal hernia repair: a network meta-analysis

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