A Long-term Follow-up: Suture versus Mesh Repair for Adult Umbilical Hernia in Saudi Patients. A Single Center Prospective Study — Oak Academic Publishing
Research ArticleOpen AccessGoogle Scholar indexed
A Long-term Follow-up: Suture versus Mesh Repair for Adult Umbilical Hernia in Saudi Patients. A Single Center Prospective Study
Objective: To report results of mesh repair vs. the modified Mayo’s suture overlap in the surgical treatment of adult umbilical and paraumbilcal hernias in our medical center. Patients & Methods: The study is a Saudi single center single surgeon trial composed of sixty two patients. It was performed in the Surgical Department of King Abdul-Aziz University Hospital at Jeddah. The patients were randomly assigned into 2 groups. Group A patients underwent onlay mesh repair while modified Mayo’s repair was used in group B patients. Median follow-up was 28 months, and data were collected regarding size of hernia, type of the operation, complications, length of follow-up and the recurrence rate. Chi square test was used to compare results at 0.05 levels. Results: Complication was reported in 17% in group A and 8% in group B .There was no difference in scar pain, cosmetic result, and overall patient satisfaction between both groups. The recurrence rate was 10% for mesh repair and 18.8% for suture repair. Conclusions: Despite higher complication rate, mesh repair is superior to suture repair due to lower recurrence rate. Suture repair still has a place under certain circumstances, also it is simple less costly and has insignificant infection rate.
M. Sukeik, B. Alkari and B. J. Ammori, “Abdominal Wall Hernia during Laparoscopic Gastric Bypass: A Serious Consideration,” Obesity Surgery, Vol. 17, No. 6, 2007, pp. 839-842. doi:10.1007/s11695-007-9129-8
T. Anthony, P. C. Bergen, L. T. Kim, M. Henderson, T. Fahey, R. V. Rege and R. H. Turnage, “Factors Affecting Recurrence Following Incisional Herniorrhaphy,” World Journal of Surgery, Vol. 24, Vo. 1, 2000, pp. 95-101.
G. Birgisson, A. E. Park, M. J. Mastrangelo, D. B. Witzke and U. B. Chu, “Obesity and Laparoscopic Repair of Ventral Hernias,” Surgical Endoscopy, Vol. 15, No. 12, 2001, pp. 1419-1422.
L .Venclauskas, J. Silanskaite and M. Kiudelis, “Umbilical Hernia: Factors Indicative of Recurrence Medicina” Kaunas, Vol. 44, No. 11, 2008, pp. 855-859.
O. M. Askar, “Surgical Anatomy of the Aponeurotic Expansions of the Anterior Abdominal Wall,” Annals of The Royal College of Surgeons of England, Vol. 59, No. 4, 1977, pp. 313-321.
R. Walmsley, “The Sheath of the Rectus Abdominis,” Journal of Anatomy, Vol. 71, No. 3, 1937, pp. 404-414
V. S. Menon and T. H. Brown, “Umbilical Hernia in Adults: Day Case Local Anaesthetic Repair,” Journal of Postgraduate Medicine, Vol. 49, No. 2, 003, pp. 132-133.
H. Lau and N. G. Patil, “Umbilical Hernia in Adults,” Surgical Endoscopy, Vol. 17, No. 12, 2003, pp. 2016-2020. doi:10.1007/s00464-003-9027-7
S. Sauerland, C. G Schmedt, S. Lein, J. L. Bernhard and R. Bittner, “Primary Incisional Hernia Repair with or without Polypropylene Mesh: A Report on 384 Patients with 5-Year Follow-Up,” Langenbeck’s Archives of Surgery, Vol. 390, No. 5, 2005, pp. 408-412. doi:10.1007/s00423-005-0567-2
K. A. LeBlanc, B. T. Heniford and G. R. Voeller, “Materials and Techniques to Reduce MRSA and Other Infections,” Innovations in Ventral Hernia Repair A Supplement to Contemporary Surgery, April 2006, pp. 1-8. www.Contemporary Surgery.com
W. A. B. Jacobus, R. W. Luijendijk, W. C. J. Hop, J. A. Halm, E. G. G. Verdaasdonk and J. Jeekel, “Long-Term Follow-Up of a Randomized Controlled Trial of Suture Versus Mesh Repair of Incisional Hernia,” Annals of Surgery, Vol. 240, No. 4, 2004, pp. 578-583.
P. Sanjay, T. D. Reid, E. L. Davies, P. J. Arumugam and A. Woodward, “Retrospective Comparison of Mesh and Sutured Repair for Adult Umbilical Hernias,” Hernia, Vol. 9, No. 4, 2005, pp. 248-251.
J. A. Halm, J. Heisterkamp, H. F. Veen and W. F. Weidema, “Long-Term Follow-Up after Umbilical Hernia Repair: Are There Risk Factors for Recurrence after Simple and Mesh Repair,” Hernia, Vol. 9, No. 4, 2005, pp. 334-337. doi:10.1007/s10029-005-0010-1
L. P. Andersen, M. Klein., I. G?genur and J. Rosenberg, “Incisional Hernia after Open Versus Laparoscopic Sigmoid Resection,” Surgical Endoscopy, Vol. 22, No. 9, 2008, pp. 2026-2029. doi:10.1007/s00464-008-9924-x
A. N. Kingsnorth, M. K. Shahid, A. J. Valliattu, R. A. Hadden and C. S. Porter, “Open Onlay Mesh Repair for Major Abdominal Wall Hernias with Selective Use of Components Separation and Fibrin Sealant,” World Journal of Surgery, Vol. 32, No. 1, 2008, pp. 26-30. doi:10.1007/s00268-007-9287-9
F. Müller-Riemenschneider, S. Roll, M. Friedrich, J. Zieren, T. .Reinhold, J. M. von der Schulenburg, W. Greiner and S. N. Willich, “Medical Effectiveness and Safety of Conventional Compared to Laparoscopic Incisional Hernia Repair: A Systematic Review,” Surgical Endoscopy, Vol. 21, No. 12, 2007, pp. 2127-2136. doi:10.1007/s00464-007-9513-4
N. Aslani and C. J. Brown, “Does Mesh Offer an Advantage over Tissue in the Open Repair of Umbilical Hernias? A Systematic Review and Meta-Analysis,” Hernia, Vol. 14, No. 5, 2010, pp. 455-462. doi:10.1007/s10029-010-0705-9
A. Arroyo, et al.,“Mesh Versus Suture Repair for Umbilical Hernias a Prospective Randomized Clinical Trial Comparing Suture and Mesh Repair of Umbilical Hernia in Adults,” British Journal of Surgery, Vol. 88, No. 10, 2001, pp. 1321-1323. doi:10.1046/j.0007-1323.2001.01893.x
M. Korenkov, S. Sauerland, M. Arndt, et al., “Randomized Clinical Trial of Suture Repair, Polypropylene Mesh or Autodermal Hernioplasty for Incisional Hernia,” British Journal of Surgery, Vol. 89, No. 1, 2002, pp. 50-56. doi:10.1046/j.0007-1323.2001.01974.x
S. S. Ching, A. I .Sarela, S. P. Dexter, et al., “Comparison of Early Outcomes for Laparoscopic Ventral Hernia Repair between Nonobese and Morbidly Obese Patient Populations,” Surgical Endoscopy, Vol. 22, No. 10, 2008, pp. 2244-2250. doi:10.1007/s00464-008-0039-1
R. Vilallonga, J. M. Fort, O. Gonzalez, J. A. Baena, A. Lecube and M. Armengol, “Management of Patients with Hernia or Incisional Hernia Undergoing Surgery for Morbid Obesity,” Journal of Obesity, 2011, pp. 860-942.
T. Datta, G. Eid, N. Nahmias and R. M. Dallal, “Management of Ventral Hernias during Laparoscopic Gastric Bypass,” Surgery for Obesity and Related Diseases, Vol. 4, No. 6, 2008, pp. 754-757. doi:10.1016/j.soard.2008.03.246
G. M. Eid, S. G. Mattar, G. Hamad, D. R. Cottam, J. L. Lord, A. Watson, R. M. Dallal and P. R. Schauer, “Repair of Ventral Hernias in Morbidly Obese Patients Undergoing Laparoscopic Gastric Bypass Should not be Deferred,” Surgical Endoscopy, Vol. 18, No. 2, 2004, pp. 207-210. doi:10.1007/s00464-003-8915-1
S. Das, “Simultaneous Umbilical Hernia Repair in Patients Undergoing Laparoscopic Cholecystectomy: Is Obesity a Risk Factor for Recurrence?” Journal of Postgraduate Medicine, Vol. 54, No. 1, 2008, pp. 58-59. doi:10.4103/0022-3859.39199
M. Asolati, S. Huerta, G. Sarosi, R. Harmon, C. Bell and T. Anthony, “Predictors of Recurrence in Veteran Patients with Umbilical Hernia: Single Center Experience,” The American Journal of Surgery, Vol. 192, No. 5, 2006, pp. 627-630. doi:10.1016/j.amjsurg.2006.08.022