Online ISSN: 2515-8260

Keywords : Hernia

Comparison of Treatment Modalities for the Management of Umbilical Hernia in Pregnancy

Jagadish Kumar CD, Supritha J, Manjunath G N, Haritha C, R C Krishna Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2075-2079

Background: To compare treatment modalities for the management of umbilical hernia in pregnancy.
Materials and Methods: 90 pregnant female patients with umbilical hernias were divided into 3 groups of 30 each. Group I were undergoing para-umbilical hernia repair by pre-peritoneal mesh insertion through CS incision, group II were undergoing paraumbilical hernia repair by infra- or supra-umbilical incision during CS incision and group III were undergoing paraumbilical hernia repair by infra- or supra-umbilical incision later on after healing of the CS wound. Each group had 30 patients. Complications were recorded in each group.
Results: Location was infraumbilical in 45%, 52% and 57% and supraumbilical in 55%, 48% and 43%. Surgical operative time (min) was 60 seen in 40%, 55% and 55%, 90 in 35%, 25% and 25%, 120 in 25%, 20% and 20%. Location of mesh was sublay in 100%, 42% and 25% and onlay in 0, 58% and 75%. Duration of hospital stay was 2 days in 30%, 35% and 38%, 3 days in 48%, 40% and 36% and 4 days in 22%, 25% and 26%. The difference was significant (P< 0.05). Complications in group I, group II and group III was wound infection in 1, 4 and 3, wound dehiscence in 1, 3 and 2, skin flaps ischemia  in 0, 1 and 2 and seroma in 0, 2 and 1 respectively. The difference was significant (P< 0.05) (Table II).
Conclusion: Performing para-umbilical hernia repair by insertion of a pre-peritoneal mesh simultaneously during performing CS through the same skin incision is the best method of management of para-umbilical hernia in pregnant woman

A comparative study of on-lay mesh repair and retro-rectus mesh placement in incisional hernia repair

Dr. Dinesh Kumar Sharma, Dr. Shiv Kumar Bunkar, Dr. Naresh Kumar, Dr. Rahul Yadav, Dr. Poornima Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 480-487

Background: Incisional hernia continues to be one of the common post-operative complication of
abdominal surgery. Newer techniques have been added for hernia repair including prosthetic mesh repair
and the laparoscopic repair, which have been reported to produce better results. This study aimed to
compare on-lay mesh repair and retro-rectus mesh placement.
Material and Methodology: The current study was a prospective study conducted in the Department of
General Surgery, J.L.N. Medical College & Attached Group of Hospital, Ajmerwith an aim to evaluate
and compare the efficacy of on-lay mesh repair and retro-rectus mesh placement for repair of incisional
hernia in terms of VAS score for pain post-operatively, to compare the duration of the surgery, hospital
stay between the two repair techniques and to compare the early and late complications between the two
repair techniques on a total 50 patients (25 patients of onlay and 25 patients for retrorectus repair).
Results: There is significant lower complication i.e. blood loss, pain, seroma formation, surgical duct
infection, sinus formation and recurrence in sublay mesh repair and blood loss is also significantly lower,
while operative time and blood loss during surgery is higher in comparison to onlay mesh placement.
Conclusion: In our study there are significant lower complication in sublay repair than onlay repair.
Thus, proved the sublay repair a better approach for the ventral hernia repair than the onlay repair.

A Clinical Study of Acute Intestinal Obstruction – Changing Etiologic Pattern

Azaharuddin Mohammad, Vikram Reddy G

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1253-1261

Background: Acute intestinal obstruction (AIO) is a common surgical emergency,
requiring urgent diagnosis and prompt treatment. The cause of bowel obstruction has
changed dramatically during the past century. Varying etiologic pattern has been noted
in developing nations as compared to the industrialized nations.
Materials and Methods: This was a prospective study comprising of all the 68 patients
admitted between August 2020 and August 2021 in the Department of General Surgery,
Govt Medical Collge & Hospital, Suryapet with a clinical diagnosis of AIO and
operated. The aim was to study the etiological pattern and other characteristics of AIO
and to look for any variation in the pattern in this region.
Results: Cases operated for AIO constituted 6.84% of all emergency surgeries. The
most common cause of AIO was complicated hernia (n=23, 33.82%) followed by
adhesions (n=14, 20.59%) and abdominal tuberculosis (n=10, 14.71%). The mean age of
presentation was 46.55 years ± 15.76 years and male to female ratio was 2:1. The most
common symptom was pain abdomen (n=63, 92.65%) while the most common sign was
tachycardia (n=66, 97.06%). The most common preceding surgery leading to AIO due
to adhesions was open appendicectomy and the most common complication was surgical
site infection (n=15, 19.12 %). There were 4 mortalities (5.88%).
Conclusion: Obstructed hernia, though the leading etiology for AIO in this study, has
lower incidence compared to similar studies, mostly due to improving socio-economic
status of people and better accessibility to health care in this region. Adhesions, has a
considerably high incidence, probably due to increased number of timely surgeries for
diseases that previously went untreated, such as surgeries for various intra-abdominal
malignancies. Tuberculosis is the third most common cause of AIO in this study and is
mainly attributed to increasing incidence of HIV and its coexistence with tuberculosis.