A meta-analysis for efficacy of prophylactic antibiotics on tension-free hernia repair

doi:10.16139/j.1007-9610.2022.02.017

Abstract

Abstract:

Objective To perform a meta-analysis of randomized controlled trial (RCT) comparing prophylactic antibiotics with placebo in patients with tension-free hernia repair for clinical effectiveness. Methods RCTs were searched from electronic Chinese databases including: ①China Biology Medicine Disc, ②China National Knowledge Infrastructure, ③China Science and Technology Journal Database, and ④Vanfund Urban Investment & Development, as well as electronic foreign databases including: PubMed, Cochrane Library, and Embase. The Review manager software (version 5.3) was used for statistical analysis. Results A total of 10 RCTs with both prophylactic antibiotic group and placebo group involving 3 659 patients were included. It was shown in this meta-analysis that there was no significant difference in the incidence of postoperative superficial incisional surgical site infection (SSSI) in low-risk environments (RR=0.74, 95% CI: 0.45-1.24) or postoperative deep surgical site infection (DSSI) (RR=0.71, 95% CI: 0.23-2.21) between two groups. The results from 4 RCTs showed that incidence of postoperative SSSI in high-risk environments in prophylactic antibiotic group was lower than that in placebo group(RR=0.34, 95%CI: 0.12-0.95, P=0.04). Conclusions Prophylactic antibiotics before tension-free hernia repair may help to reduce the incidence of postoperative SSSI in high-risk environments, but there is no significant evidence for that in low-risk environments.

Key words: Inguinal hernia, Tension-free hernia repair, Antibiotic, Meta-analysis, Randomized controlled trial

CLC Number:

R656.21

JIANG Weirong, YU Yongjiang. A meta-analysis for efficacy of prophylactic antibiotics on tension-free hernia repair[J]. Journal of Surgery Concepts & Practice, 2022, 27(02): 173-179.

Figures/Tables 9

References 32

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纳入研究	分组	n	男/女	年龄（岁）	腹股沟疝类型	手术时间(min)	干预措施	随访时间(d)
Aufenacker等^[13] 2004	抗生素安慰剂	503 505	481/22 490/15	58.28±12.9 58.22±13.2	原发性单侧与双侧腹股沟疝	40 (30~50) 40 (28~51)	头孢呋辛1.5 g,术前静滴 1次	84
Ergul等^[14] 2012	抗生素安慰剂	100 100	95/5 89/11	48±17 50±15	原发单侧腹股沟疝	60 (35~160) 60 (40~135)	头孢唑林1 g,术前30 min 静滴1次	30
Jain等^[15] 2008	抗生素安慰剂	60 60	60/0 60/0	41.28±11.49 40.2±9.84	原发单侧腹股沟疝	56.33±11.67 60.33±6.81	阿莫西林克拉维酸 1.2 g,术前30 min静滴1次	28
Mazaki等^[16] 2014	抗生素安慰剂	100 100	89/11 94/6	69 (57~76) 72 (60~77)	单侧与双侧腹股沟疝	66.3±25.4 65.2±27.1	头孢唑林 1 g,术前30 min 静滴1次	90
Othman^[17] 2011	抗生素安慰剂	50 48	48/2 48/0	43.4±19.8 44.5±20.5	单侧与双侧腹股沟疝	38.8±10.8 40.9±11.1	阿莫西林克拉维酸1.2 g,术前30 min静滴1次	30
Perez等^[18] 2005	抗生素安慰剂	180 180	176/4 177/3	61.37±13.2 60.8±14.5	原发单侧腹股沟疝	52.18±16.4 54.07±15.3	头孢唑林 1 g,术前静滴1次	28
Tzovaras等^[19] 2007	抗生素安慰剂	190 189	179/11 177/12	63 (17~87) 63 (15~90)	单侧与双侧腹股沟疝	52.18±16.4 54.07±15.3	克拉维酸氨苄西林1.2 g,术前静滴1次	30
Tzovaras等^[19] 2007	抗生素安慰剂	190 189	179/11 177/12	63 (17~87) 63 (15~90)	单侧与双侧腹股沟疝	45 (20~90) 45 (20~80)	克拉维酸氨苄西林1.2 g,术前静滴1次	30
Yerdel等^[20] 2001	抗生素安慰剂	136 133	123/13 126/7	55.57±15.1 55.78±13.8	原发单侧腹股沟疝	64.18±22.8 62.78±19.3	氨苄西林舒巴坦1.5 g,术前静滴1次	360
严丽华等^[21] 2013	抗生素安慰剂	445 440	405/40 400/40	65±10 62±12	原发与复发腹股沟疝	- -	头孢唑林2.0 g,术前30 min 静滴1次	30
何金华等^[22] 2013	抗生素安慰剂	70 70	63/7 62/8	62.02±10.03 61.25±10.68	原发与复发腹股沟疝	37±6 38±5	头孢唑林 1.5 g,术前30 min 静滴1次	-