Open Or Laparoscopic Mesh Repair Of Incisional Hernia In Patients That Underwent Liver Transplantation: A Systematic Review And Proportional Meta-Analysis

Background Incisional hernias, that significantly affect the quality of life of patients, are common complications especially after major surgery, such as liver transplantation. The purpose of this meta-analysis is to outline the available evidence on the complications occurring after mesh implantation as a treatment of ventral incisional hernias (VIH) in liver transplant patients. Methods MEDLINE, SCOPUS, Clinicaltrials.gov, CENTRAL and Google Scholar databases were searched for articles that reported the complications after mesh repair in patients that had undergone liver transplantation. Results Eighteen studies, that involved 640 liver transplant patients who developed incisional hernia, were included. 546 of them underwent surgical repair with mesh implantation. 144 (26%) patients developed postoperative complications, and the most common was surgical site infection (17%). The pooled complication rate of open mesh repair of incisional hernia after liver transplantation was 23% (95% CI = 11%-37%), whereas the pooled complication rate of laparoscopic mesh repair was 20% (95% CI = 12%-29%). Conclusion Laparoscopic VIH repair with the implantation of mesh showed promising results, since the percentage of patients with postoperative complications was lower compared to the available data of those who underwent open VIH repair with mesh.