SP9.11 Comparison of non-mesh Desarda technique versus Lichtenstein technique for inguinal hernia repair: A systematic review and meta-analysis of 14 comparative studies

Abstract

Abstract Background The aims of this systematic review and meta-analysis were to compare non-mesh Desarda technique (DT) with the standard mesh-based Lichtenstein technique (LT) for inguinal hernia repair. Methods A systematic literature search for comparative studies comparing between DT and LT was conducted using electronic databases and Google scholar service. Studies were evaluated for hernia recurrence, post-operative complications, and time to return to work. We pooled the data using fixed effects model and random effects model after assessing the heterogeneity among the included studies. Results A total number of 14 studies were included in this meta-analysis with a total number of 3673 patients divided between Desarda group (n=1794) and Lichtenstein group (n= 1879). There was no difference in terms of recurrence between the Desarda repair and Lichtenstein repair group [P = 0.47]. There was a significant lower rate of overall post-operative complications [P=0.0001], seroma [P=0.0002] and (SSI [P = 0.03] in the Desarda group. The two groups showed comparable results for haematoma [P=0.12], scrotal oedema [P=0.25], and testicular atrophy [P=0.15]. Moreover, Desarda group was associated with shorter operative time and return to work when compared to Lichtenstein group, [P=0.01] and [P=0.008], respectively. Conclusion DT and LT were found to have comparable results in terms of hernia recurrence rate, haematoma formation, and testicular atrophy. However, DT is superior to LT in terms of reducing postoperative mesh-attributed complications, such as SSI and Seroma formation besides shorter operative time and return to work. We recommend performing a well-designed, large cohort RCT to evaluate the cost-effectivity and impact in less economically developed countries.