ObjectiveTo systematically review the effectiveness and safety of the open preperitoneal approaches and the Lichtenstein technique in the repair of inguinal hernias. MethodsDatabases including PubMed, EMbase, Web of Science, The Cochrane Library (Issue 10, 2013), CBM, CNKI, WanFang Data and VIP were electronically searched for relevant studies from their inception to October 2013. References of the included studies were also retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then, meta-analysis was performed using RevMan 5.2.5 software. ResultsA total of 9 RCT involving 1 246 patients were included. The results of meta-analysis showed that:compared with Lichtenstein repair, the preperitoneal technique was associated with a lower incidence of chronic pain (RR=0.39, 95%CI 0.26 to 0.58, P < 0.000 01), sensation of a foreign body (RR=0.49, 95%CI 0.31 to 0.79, P=0.003), recurrence (RR=0.37, 95%CI 0.15 to 0.89, P=0.03), and hematoma (RR=0.41, 95%CI 0.26 to 0.67, P=0.000 3). However, there was no significant difference in the incidence of wound infection (RR=0.89, 95%CI 0.29 to 2.76, P=0.85) and urine retention (RR=0.75, 95%CI 0.35 to 1.61, P=0.46). ConclusionThe open preperitoneal approach is a feasible alternative for inguinal hernia repair with less postoperative complication compared with Lichtenstein procedure. Due to the limited quantity and quality of the included studies, the aforementioned conclusion still needs to be verified by conducting more high quality studies.
ObjectiveTo carry out a retrospective study of the reporting quality and current situation of the systematic reviews (SRs)/meta-analyses (MAs) in pediatric field in China, as well as compliance with the PRISMA and MOOSE guidelines. MethodsSeven core Chinese pediatric journals were hand-searched. Two reviewers extracted data independently using predesigned data extraction form, crosschecked data, and discussed to solve discrepancy. The PRISMA and MOOSE guidelines were used to assess the reporting quality respectively, and subgroup analysis was conducted by different total cites and different published time. SPSS 22.0 was used to for statistical analysis. Percentage was used to describe categorical data and Chi-square test was used to compare the difference among groups. ResultsA total of 157 SRs/MA were included. The proportion of SRs/MA related to interventions was the biggest (61.1%, 96 SRs/MA). (1) The coincidence rate of SRs/MA related to interventions in the PRISMA checklist was better:the coincidence rate of twenty entries was above 50%; (2) The coincidence rate of observational SRs/MA in the MOOSE guidelines was not so good:the coincidence rate of 15 entries was less than 50%, even some of them were less than 20%. There were no significant difference between different total cites (≤5 vs. > 5) in PRISMA and MOOSE guidelines. (3) The coincidence rate of SRs/MA related to interventions had been improved to some extent in most of items after the PRISMA guidelines published, and the differences were statistically significant respectively in No. 8, 19, 20, and 23 (P≤0.05). ConclusionsThe number of SRs/MA published in the pediatric journals in China is increasing generally, the coincidence rate of SRs/MAs related to interventions have been obviously improved after the PRISMA guidelines published, and it's better than the coincidence rate of observational SRs/MAs in MOOSE guidelines. In a word, we should pay more attention to the quality of SRs/MAs, but not just the number.