Desarda versus Lichtenstein inguinal hernia repair: A meta‐analysis of randomized controlled trials.

Background: The Lichtenstein technique is the gold standard for adult open inguinal hernia repair with mesh. The Desarda technique emerged in 2001 as a novel, promising non‐mesh technique that has demonstrated low recurrence and postoperative complications. Methods: We searched MEDLINE, the Cochrane Central Register of Clinical Trials, and Embase for randomized controlled trials (RCT) published until April 2024. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random‐effects model. Heterogeneity was assessed using Cochran's Q test and I2 statistics, with p‐values <0.10 and I2>25% considered significant. Statistical analysis was performed using the R software, version 4.1.2. Results: Eighteen RCTs comprising 1756 patients were included, of whom 861 (49%) were submitted to Desarda and 895 (51%) were submitted to Lichtenstein. Desarda was associated with lower seroma rates (OR 0.55; 95% CI 0.35–0.89; and p = 0.014), less operative time (MD −8.6 min; 95% CI −14.5 to −2.8; and p < 0.01), lower postoperative pain on day one (MD −1.3 VAS score; 95% CI −2.3 to −0.3; p < 0.01) or chronic pain (OR 0.32; 95% CI 0.12–0.88; and p = 0.028), and faster return‐to‐work activities (MD −2.1 days; 95% CI −3.7 to −0.6; and p < 0.01). The recurrence rate was 1.4% for Desarda versus 2.1% for Lichtenstein, with no statistical difference between techniques. Conclusion: In this meta‐analysis, Desarda significantly decreases seroma operative time, postoperative pain on day 1, chronic pain, and return‐to‐work activities. [ABSTRACT FROM AUTHOR]