Experience of Open Mesh Hernia Repair at a Teaching Hospital in Addis Ababa, Ethiopia- A Three Year Retrospective Study

Engida Abebe Gelan

Abstract


Background- the treatment of hernias has been evolving very fast in the last few decades. The use of mesh for hernia repair has become increasingly popular & many centers considered it as a standard of care.

Objective - To determine the rate and types of abdominal wall hernias treated with mesh repair techniques and outcomes of patients.

Methods-A retrospective review medical records of all adult patients who underwent open mesh repair at St. Paul’s Hospital Millennium Medical College from September 2013 to August 2016. 

Results- Hernia surgeries made 8% of adult elective surgeries. Of these, 130(40.9 %) had mesh repair. Incisional hernias (IH) 68(52.3%) and groin hernias 44(33.8%) being the most common forms repaired with mesh. Except inguinal hernias all hernias were more common in females. Laparotomy for bowel surgery and 29(42.6%) and cesarean section/gynecologic surgeries, 27(29.7%) were the most common surgeries resulting IH. Of IH 57.4 %( n=39) had emergency surgery & 33.8% (n=23) had a low midline incision. Recurrent hernias accounted for 28.5 %( n=37) of the cases repaired with mesh.  Postoperative complication was seen in 14 patients (10.8%) surgical site infection being the main form followed by seroma formation (n=3) & recurrence (n=3). There was an increased rate of complications in females (p=0.043) & in patients with co-morbidity (p=0.041). No death.

 

Conclusion- Our study found that meshes are being used increasingly for incisional & recurrent inguinal hernias. Outcomes of our patients are comparable to published literatures.

 

Key words-Inguinal hernia; incisional hernia; Mesh repair


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References


Mukesh Sangwan1, Vijayata Sangwan, Mahender Garg, Parveen Mahendirutta, Uma Garg. Abdominal wall hernia in a rural population in India —Is spectrum changing? Open Journal of Epidemiology. 2013; 3: 135-138

David L Sanders. Andrew N Kingsnorth. The modern management of incisional hernias. BMJ.2012;344:e2843doi:10.1136/bmj.e2843

O.O Ayandipo1, O.O Afuwape1, D.O Irabor1 and A.I. Abdurrazzaaq. Adult Abdominal Wall Hernia In Ibadan. Ann Ibd. Pg. Med. 2015;13(2): 94-99

Le Huu Nho R, Mege D, Ouaïssi M, Sielezneff I, Sastre B. Incidence and prevention of ventral incisional hernia. J Visc Surg. 2012;149(5 Suppl):e3-14. doi: 10.1016/j.jviscsurg.2012.05.004. Epub 2012 Nov 9.

Mudge M, Hughes LE. Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg. 1985;72(1):70-1.

Pereira JA, et al. Elevada incidencia de hernia incisional tras reseccio´n abierta y laparosco´ pica por ca´ncer colorrectal. Cir Esp. 2013;91:44–9.

Seiler CM1, Diener MK. Which abdominal incisions predispose for incisional hernias? Chirurg. 2010 ;81(3):186-91. doi: 10.1007/s00104-009-1816-7.

Den Hartog D, Dur AH, Tuinebreijer WE, Kreis RW. Open surgical procedures for incisional hernias. Cochrane Database Syst Rev. 2008 16;(3):CD006438. doi: 10.1002/14651858.CD006438.pub2.

G Weiser , Alex B Haynes , George Molina and e tals . Size and distribution of the global volume of surgery in 2012. Bulletin of the World Health Organization 2016;94:201-209F. doi: http://dx.doi.org/10.2471/BLT.15.159293

Garba ES. The pattern of adult external abdominal hernias in Zaria. Nigerian Journal of Surgical Research. 2000;2(1):12-5.

Iqbal MN, Akhter S, Irfan M. Prevalence of hernia in relation to various risk factors in Narowal, Pakistan. Sci Lett. 2015;3(1):29-32.

Vrijland WW, van Den Tol MP, Luijendijk RW, Hop WC, Busschbach JJ, De Lange DC, Van Geldere D, Rottier AB, Vegt PA, Ijzermans JN, Jeekel J. Randomized clinical trial of non‐mesh versus mesh repair of primary inguinal hernia. British journal of surgery. 2002 ;89(3):293-7.

Pillay Y, Naidoo NM, Madiba TE. Incisional hernia: Experience in a single surgical unit. East and Central African Journal of Surgery. 2007;12(1):42-6.

Kuubiere CB, Abass A. THE USE OF POLYPROPYLENE-MESH, PRE-PERITONEALLY FOR INCISIONAL HERNIA REPAIR IN NORTHERN GHANA. European Journal of Advanced Research in Biological and Life Sciences Vol. 2015;3(2).

Hasan DS, Salayta WM. Incisional hernia of elective midline caesarean section: incidence and risk factors. Ibnosina Journal of Medicine and Biomedical Sciences. 2011 26;3(6):205-10.

Richards C, Edwards J, Culver D, Emori TG, Tolson J, Gaynes R, National Nosocomial Infections Surveillance (NNIS) System. Does using a laparoscopic approach to cholecystectomy decrease the risk of surgical site infection?. Annals of surgery. 2003;237(3):358-62.

Ingraham AM, Cohen ME, Ko CY, Hall BL. A current profile and assessment of North American cholecystectomy: results from the American College of Surgeons National Surgical Quality Improvement Program. Journal of the American College of Surgeons. 2010 ;211(2):176-86.

Flum DR, Horvath K, Koepsell T. Have outcomes of incisional hernia repair improved with time?: A population-based analysis. Annals of surgery. 2003 ;237(1):129-35.

Chauhan PV, Desai HK. Comparative Study on Surgical Techniques of Incisional Hernia Repair. National Journal of Medical Research. 2016;6(3):230-2.

Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Annals of surgery. 2004 1;240(4):578-85.

Vannelli A, Battaglia L, Poiasina E, Corsi C, Del Conte C, Fiore F, Valera V. A tension-free technique for the repair of large incisional hernias during abdominal surgery: results and long-term outcome: general surgery. South African Journal of Surgery. 2008 ;46(4):112-5.


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