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Amato B et al. – Shouldice herniorrhaphy is the best non–mesh technique in terms of recurrence, though it is more time consuming and needs a slightly longer post–operative hospital stay. The use of mesh is associated with a lower rate of recurrence. The quality of included studies, assessed with jaded scale, were low. Patients have similar characteristic in the treatment and control group but seems more healthy than in general population, this features may affect the dimension of effect in particularly recurrence rate could be higher in general population. Lost to follow–up were similar in the treatment and control group but the reasons were often not reported. The length of follow–up vary broadly among the studies from 1 year to 13.7 year.

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