Comparison of open preperitoneal and Lichtenstein repair for inguinal hernia repair: a meta-analysis of randomized controlled trials.

BACKGROUND The aim of this article was to compare the outcomes of the open preperitoneal approaches and the Lichtenstein technique in the repair of inguinal hernias. METHODS A systematic literature review was undertaken to identify studies comparing the outcomes of open preperitoneal and Lichtenstein techniques in the repair of inguinal hernias. RESULTS The present meta-analysis pooled the effects of outcomes of a total of 2,860 patients enrolled into 10 randomized controlled trials and 2 comparative studies. The preperitoneal technique was associated with a lesser incidence of recurrence (odds ratio = .51; 95% confidence interval, .28-.92). However, statistically there was no difference in the incidence of chronic pain, hematoma, wound infection, testicular problem, urinary problem, numbness, inguinal parenthesis, and operative time. CONCLUSIONS The open preperitoneal approach is a feasible alternative for the standard Lichtenstein procedure with similar complication rates and potentially less postoperative recurrence.