Impact of sex on ventral hernia repair outcomes: A systematic review and meta-analysis

Am J Surg. 2023 Sep;226(3):385-392. doi: 10.1016/j.amjsurg.2023.06.026. Epub 2023 Jun 29.

Abstract

Background: Given the variability in abdominal physiology and hernia presentation between sexes, better comprehension of sex-related differences in outcomes would tailor surgical approach and counseling regarding postoperative outcomes. This meta-analysis aims to appraise the effect of sex on the outcomes of ventral hernia repair.

Methods: A literature search in PubMed, EMBASE and Cochrane selected studies comparing outcomes of ventral hernia repair between sexes. Postoperative outcomes were assessed by pooled and meta-analysis. Statistical analysis was performed using RevMan 5.4.

Results: We screened 3128 studies, reviewed 133, and included 18 observational studies, which encompassed 220,799 patients following ventral hernia repair. Postoperative chronic pain was significantly higher in female (OR 1,9; 95% CI 1,64-2,2; p ​< ​0,001). There were no significant differences in complications, readmission, or recurrence rates between females and males.

Conclusion: Female sex is associated with a higher risk of postoperative chronic pain following ventral hernia repair.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Chronic Pain* / epidemiology
  • Chronic Pain* / etiology
  • Female
  • Hernia, Ventral* / complications
  • Hernia, Ventral* / surgery
  • Herniorrhaphy / adverse effects
  • Humans
  • Male
  • Pain, Postoperative / etiology
  • Surgical Mesh / adverse effects