UNASSIGNED: There is no consensus on the ideal location for mesh placement in open @entity4037 (OVHR). We aim to identify the mesh location associated with the lowest rate of recurrence following OVHR using a systematic review and meta-analysis. A search was performed for studies comparing at least two of four locations for mesh placement during OVHR (onlay, inlay, sublay, and underlay). Outcomes assessed were @entity547 recurrence and @entity281 ( @entity281 ). Pairwise meta-analysis was performed to compare all direct treatment of mesh locations. A multiple treatment meta-analysis was performed to compare all mesh locations in the Bayesian framework. Sensitivity analyses were planned for the following: studies with a low risk of bias, incisional @entity547 , by @entity547 size, and by mesh type (synthetic or biologic). Twenty-one studies were identified (n  =  5,891). Sublay placement of mesh was associated with the lowest risk for recurrence [OR 0.218 (95  % CI 0.06-0.47)] and was the best of the four treatment modalities assessed [Prob (best)  =  94.2  %]. Sublay was also associated with the lowest risk for @entity281 [OR 0.449 (95  % CI 0.12-1.16)] and was the best of the 4 treatment modalities assessed [Prob (best)  =  77.3  %]. When only assessing studies at low risk of bias, of incisional @entity547 , and using synthetic mesh, the probability that sublay had the lowest rate of recurrence and @entity281 was high. Sublay mesh location has lower complication rates than other mesh locations. While additional randomized controlled trials are needed to validate these findings, this network meta-analysis suggests the probability of sublay being the best location for mesh placement is high.

Mesh Location in Open XXXX Repair: A Systematic Review and Network Meta-analysis.

@entity281 :: ('MESH:D007239', 'Disease') :: ['surgical site infection', 'SSI'] @entity4037 :: ('MESH:D006555', 'Disease') :: ['ventral hernia repair'] @entity547 :: ('MESH:D006547', 'Disease') :: ['hernia', 'hernias']
@entity4037 :: (MESH:D006555,Disease) :: ['Ventral Hernia']
