EFFECTIVENESS OF MESH VS ANATOMIC REPAIR IN MANAGEMENT OF PARAUMBILICAL HERNIAS – A COMPARATIVE STUDY
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 11574-11593
AbstractBackground:The purpose of the study is to determine the appropriate mode of managing paraumbilical hernias in terms of complications and recurrences.
Materials and Methods: In this clinical study, 50 patients with paraumbilical hernia were admitted and underwent surgery subsequently from October 2019 to September 2021. The patients were studied for, clinical features, treatment and postoperative complications. Cases were prepared for surgery after preoperative correction of anemia, hypertension, obesity, diabetes and local skin conditions. All patients underwent surgical procedure after following preoperative preparation.
Results: The present study shows that majority of the patients are in the age group of 40-60years, i.e., between 4th and 6th decades of life (52%). 2 patients are above 70 years. In this study, the patients were categorized into two groups based on the procedure performed in accordance to the size of the defect: Both anatomical and prosthetic mesh repair was performed across all defect sizes and the outcomes compared. Among 28 patients with a defect size of 2-5cms, anatomical repair was performed in 18 patients (64.2%), while mesh repair was performed in 10 patients(35.7%). Among 22 patients with a defect size more than 5cms, anatomical repair was performed in 6 patients (27.2%), while mesh repair was performed in 16 patients (72.7%). Skin necrosis, wound infection, seroma and wound dehiscence were noted in this study group. Skin necrosis was seen in 2 patients (8.3%) in anatomical repair group, while 1 patient (3.8%) developed in prosthetic mesh repair group. Wound infection was seen in 2 patients (8.3%) in anatomical repair group, while 3 patients(11.5%) developed in prosthetic mesh repair group. Seroma was seen in 4 patients (16.6%) in anatomical repair group, while 2 patients(7.6%) developed in prosthetic mesh repair group. In two years of regular follow up, 2 recurrences (8.3%) were noted in the anatomical repair group while no recurrences were noted in the prosthetic mesh repair group. The subjects who underwent anatomical repair were followed up for a mean period of 14.63 months with a standard deviation of 6.67 and those who underwent prosthetic mesh repair were followed up for a mean period of 13.45 months with a standard deviation of 5.8.
Conclusion: To conclude, it can be said that in the treatment of paraumbilical hernias, prosthetic mesh repair seems superior to anatomical repair, although significant difference could not be demonstrated. Statistical significance between the two procedures probably could be obtained if the sample size and follow up period is increased.
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