TY - JOUR
T1 - Comparison of coated meshes for intraperitoneal placement in animal studies
T2 - a systematic review and meta-analysis
AU - Liu, H.
AU - van Steensel, S.
AU - Gielen, M.
AU - Vercoulen, T.
AU - Melenhorst, J.
AU - Winkens, B.
AU - Bouvy, N. D.
N1 - Funding Information:
Dr. Liu reports Grants (No. 201608420106) from China Scholarship Council, outside the submitted work. All other authors declaim no conflicts of interest.
Publisher Copyright:
© 2019, The Author(s).
PY - 2020/12
Y1 - 2020/12
N2 - Purpose Laparoscopic intraperitoneal onlay mesh in hernia repair can result in adhesions leading to intestinal obstruction and fistulation. The aim of this systematic review is to compare the effects of mesh coatings reducing the tissue-to-mesh adhesion in animal studies. Methods Pubmed and Embase were systematically searched. Animal experiments comparing intraperitoneally placed meshes with coatings were eligible for inclusion. Only studies with comparable follow-up, measurements, and species were included for data pooling and subsequent meta-analysis. Results A total of 131 articles met inclusion criteria, with four studies integrated into one comparison and five studies integrated into another comparison. Compared to uncoated polypropylene (PP) mesh, PP mesh coated with hyaluronic acid/carboxymethyl cellulose (HA/CMC) showed significantly reduced adhesion formation at follow-up of 4 weeks measured with adhesion score of extent (random effects model, mean difference,- 0.96, 95% CI - 1.32 to - 0.61, P <0.001, I-2 = 23%; fixed effects model, mean difference,- 0.94, 95% CI - 1.25 to - 0.63, P <0.001, I-2 = 23%). Compared to PP mesh, polyester mesh coated with collagen (PC mesh) showed no significant difference at follow-up of 4 weeks regarding percentage of adhesion-area on a mesh, using random effects model (mean difference - 11.69, 95% CI - 44.14 to 20.76, P = 0.48, I-2 = 92%). However, this result differed using fixed effects model (mean difference - 25.55, 95% CI - 33.70 to - 7.40, P <0.001, I-2 = 92%). Conclusion HA/CMC coating reduces adhesion formation to PP mesh effectively at a follow-up of 4 weeks, while the anti-adhesive properties of PC mesh are inclusive comparing all study data.
AB - Purpose Laparoscopic intraperitoneal onlay mesh in hernia repair can result in adhesions leading to intestinal obstruction and fistulation. The aim of this systematic review is to compare the effects of mesh coatings reducing the tissue-to-mesh adhesion in animal studies. Methods Pubmed and Embase were systematically searched. Animal experiments comparing intraperitoneally placed meshes with coatings were eligible for inclusion. Only studies with comparable follow-up, measurements, and species were included for data pooling and subsequent meta-analysis. Results A total of 131 articles met inclusion criteria, with four studies integrated into one comparison and five studies integrated into another comparison. Compared to uncoated polypropylene (PP) mesh, PP mesh coated with hyaluronic acid/carboxymethyl cellulose (HA/CMC) showed significantly reduced adhesion formation at follow-up of 4 weeks measured with adhesion score of extent (random effects model, mean difference,- 0.96, 95% CI - 1.32 to - 0.61, P <0.001, I-2 = 23%; fixed effects model, mean difference,- 0.94, 95% CI - 1.25 to - 0.63, P <0.001, I-2 = 23%). Compared to PP mesh, polyester mesh coated with collagen (PC mesh) showed no significant difference at follow-up of 4 weeks regarding percentage of adhesion-area on a mesh, using random effects model (mean difference - 11.69, 95% CI - 44.14 to 20.76, P = 0.48, I-2 = 92%). However, this result differed using fixed effects model (mean difference - 25.55, 95% CI - 33.70 to - 7.40, P <0.001, I-2 = 92%). Conclusion HA/CMC coating reduces adhesion formation to PP mesh effectively at a follow-up of 4 weeks, while the anti-adhesive properties of PC mesh are inclusive comparing all study data.
KW - Surgical mesh
KW - Tissue adhesion
KW - IPOM
KW - Systematic review
KW - Meta-analysis
KW - VENTRAL HERNIA REPAIR
KW - TERM-FOLLOW-UP
KW - ABDOMINAL ADHESIONS
KW - DIFFERENT BARRIERS
KW - PROSTHETIC MESH
KW - POLYPROPYLENE
KW - PREVENTION
U2 - 10.1007/s10029-019-02071-y
DO - 10.1007/s10029-019-02071-y
M3 - (Systematic) Review article
C2 - 31659548
SN - 1265-4906
VL - 24
SP - 1253
EP - 1261
JO - Hernia
JF - Hernia
IS - 6
ER -