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- Title
Adult groin hernia surgery in sub-Saharan Africa: a 20-year systematic review and meta-analysis.
- Authors
Ndong, A.; Tendeng, J. N.; Diallo, A. C.; Diao, M. L.; Sow, O; Mawuli, S. D.; Kalli, M.; Harissou, A.; Choua, O.; Doumga, A. D.; Togo, A. P.; Seck, M.; Ka, I.; Touré, A. O.; Diop, B.; Ba, P. A.; Diop, P. S.; Cissé, M.; Sani, R.; Konaté, I.
- Abstract
Purpose: To realize a systematic review to evaluate groin hernia surgery for adults in sub-Saharan Africa. Methods: We conducted a systematic review and meta-analysis, the primary objective of which was to determine the surgical techniques used for unilateral groin hernia surgery in sub-Saharan Africa. Studies published in the last 20 years were considered. A meta-analysis estimated the pooled prevalence with 95% confidence interval (CI) of mortality, chronic pain and recurrence. A subgroup analysis compared the rate of complications between complicated or uncomplicated hernia. Results: We included 113 articles. The most used technique was Bassini in 40.1%, followed by Lichtenstein in 29.9% and Shouldice in 12.6%. The overall mortality rate was 0.6% (95% CI 0.4–0.9). The pooled recurrence rate was 1.4% (95% CI 1.05–1.9). The pooled rate of chronic pain was 2.7% (95% CI 1.9–3.7). We found that mortality rate for complicated hernias (6.4%) was higher compared to uncomplicated hernias (0.2%). This difference was statistically significant [p ≤ 0.001; OR = 47.7; 95 CI (27.2–83.47)]. Conclusion: This review showed that pure tissue repairs are the most used techniques with Bassini and Shouldice as leading procedures. The post-operative rates of recurrence and chronic pain are low. However, there is a high heterogeneity between studies than can underestimate these pooled prevalences. The consultation at complication stage remains frequent and associated with a higher mortality. Futures studies should focus on improving the quality of studies in terms of design and follow-up to increase the degree of evidence.
- Subjects
SUB-Saharan Africa; LIECHTENSTEIN; HERNIA surgery; GROIN; CHRONIC pain; OPERATIVE surgery; DEATH rate
- Publication
Hernia, 2023, Vol 27, Issue 1, p157
- ISSN
1265-4906
- Publication type
Article
- DOI
10.1007/s10029-022-02669-9