Mesh repair versus suture plication for rectus diastasis: the results of meta-analysis

Surgical treatment is recommended for rectus diastasis (RD) patients with obvious symptoms and open method is more prevalent due to better surgical view and fewer operative difficulties compared with laparoscopic surgery. Mesh repair and suture plication are main open approaches of RD. The aim of this study was to evaluate results of RD patients undergoing mesh repair and suture plication.

We did a literature search of PubMed, Embase and Cochrane Library to find studies comparing the results of mesh repair and suture plication for RD. Seroma, infection, recurrence and difficulty performing physical activity were enrolled as outcomes and assessed. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system was used to estimate the quality of evidence for each outcome.

Two randomized controlled trials (RCTs), 1 prospective comparative study and 1 retrospective comparative research were enrolled and 253 patients were included, of which 131 were treated with mesh repair and 122 with suture plication. There was no significant difference in seroma (OR 0.65, 95%CI 0.26, 1.66, P = 0.37), infection (OR 1.19, 95%CI 0.28, 5.09, P = 0.81), recurrence (OR 0.31, 95%CI 0.03, 3.02, P = 0.31) and difficulty performing physical activity (OR 0.58, 95%CI 0.05, 6.46, P = 0.66) between mesh group and suture group.

Mesh repair for RD is comparable with suture plication in seroma, infection, recurrence and difficulty performing physical activity, and large-scale RCTs with long-term follow-up are needed to reduce the bias and optimize the analysis.