Laparoscopic versus Lichtenstein hernioplasty for inguinal hernias: a systematic review and Meta-analysis of randomized controlled trials.

Background: This meta-analysis aimed to explore the safety and efficacy of Lichtenstein versus laparoscopic hernioplasty for inguinal hernias based on eligible randomized controlled trials (RCTs). Material and methods: We searched several electronic databases to identify eligible studies based on the index words updated to March 2018.We also searched related publication sources and only included eligible RCTs in the current analysis. Relative risk (RR) or mean difference (MD) along with 95% confidence interval (95% CI) were used for the main outcome of our analysis. Results: In total, 21 studies were included with 3772 patients in the laparoscopic group and 3910 patients in the Lichtenstein group. The results indicated that compared with the Lichtenstein group, the laparoscopic surgery group had significantly increased operative time. Besides, there was no significant difference in the rate of hematoma or seroma and complications between the two groups. However, compared with the Lichtenstein group, the laparoscopic group had a higher hernia recurrence rate, a lower incidence of chronic pain and a lower rate of wound infection, but no significant difference was found. Conclusion: The results demonstrated that laparoscopic repair reduced chronic pain and wound infection compared with Lichtenstein repair. But Lichtenstein could reduce the operative time and hernia recurrence.