Comparison of complications between Mayo`s repair and Mesh repair (pre-peritoneal approach) for para umbilical hernia
Keywords:Hernia, Umbilical. Surgical Mesh. Polypropylenes. Peritoneum. Hernia, Inguinal. Hernia, Ventral. Prostheses and Implants. Laparoscopy. Umbilicus.
Objective. The purpose of the study is to compare the rate of complications in Mayo`s repair with mesh repair. (Preperitoneal approach) Design. Comparative study. Place and Duration of Study. Nishtar Hospital Multan during the period of January 2001 to August 2003. Patients and Methods. Only patients with fully reducible hernias were included in the study. Unfit patients having serious cardiac and respiratory illness, patients with obstructive and strangulated paraumbilical hernia were excluded from study. Two groups comprising of 25 patients each were made on random basis and operated (Mayo`s repair in-group one and mesh repair in-group two) randomly by surgical team. A separate file was kept for each patient. A detailed history and full physical examination and various investigations of all patients were carried out. Later on, operative findings and complications were also noted. Results. The age of the patients ranges from 20 to 60 years (mean 40 years). 80% were female while remaining 20% were male The commonest mode of presentation was swelling in the umbilical region (100%) and dragging pain in the umbilical region during heavy working (60%). On physical examination positive cough impulse was present in (80%). There was significant difference between postoperative complications in two groups. As seroma formation (8% vs 0%), wound infection (8% vs 0%), wound haematoma (12% vs 4%) was seen more in group I. However mesh infection was present in-group 2 only. Conclusion. It is concluded that recurrences after open tension free repair are rare, complications are few, and the operation is simple to perform. Optimally hernias should be repaired using mesh repair
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