HERNIORRHAPHY AND HERNIOPLASTY- THEIR RELEVANCE AS HERNIA REPAIR TECHNIQUES IN RURAL SETUP: A PROSPECTIVE STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 2
Abstract
BACKGROUND Prospective studies and Meta–analysis have indicated that non–mesh repair is inferior to mesh repair based on recurrence rates in inguinal hernia. The incidence of complications immediately and later in postoperative period in either of the repairs are also less in the mesh repairs as compared to the non-mesh repairs. MATERIALS AND METHODS Non-randomised controlled trial of 50 inguinal hernia repairs was conducted in Rural Hospital, Medical College, Loni (Ahmednagar). The subject of study was comparison between herniorrhaphy and hernioplasty as inguinal hernia repair techniques in rural setup. The sample size was considered on Convenience. The cases of inguinal hernias which were complicated with complaints of irreducibility, obstruction, strangulation and gangrene were excluded. All paediatric age group presentations of inguinal hernia were excluded. Only those cases of adult inguinal hernias of uncomplicated variety in the age group of 20 to 70 years were selected for surgery. Cases were allocated for Herniorrhaphy and Hernioplasty alternatively. Materials used were as below1. A polypropylene (Prolene) non-absorbable suture material; size #1 was used for herniorrhaphy technique. 2. A monofilament polypropylene (Prolene) non-absorbable synthetic knitted surgical mesh, of sizes 3” x 6” and 2” x 4” was used for hernioplasty technique. Followup was done by physical examination in the outpatient clinic after 1 week, 1 and 6 months and at 1 year. RESULTS In the early phase of recovery of patients who underwent herniorrhaphy, only pain (60%) and seroma formation (16%) were seen. Among the other subjects who underwent hernioplasty, pain (16%) was the only seen complication. No other complications like nerve injury, division of vas, genital oedema, orchitis, testicular atrophy, hydrocoele, aspiration pneumonia, urinary retention, venous phlebitis, or seroma formation were encountered. In subsequent followup for a period of 1 year, neither pain, recurrence nor any prosthesis-related complications were noted in any of the individuals. CONCLUSION Hernia repair with mesh is associated with lesser incidence of complications than herniorrhaphy. Repair of direct hernia has less complications than indirect hernia. The rate of complications in direct hernia (Pain & seroma) is less with hernioplasty as compared to herniorrhaphy. In indirect hernia repairs, the incidence of seroma formation is not affected by hernioplasty or herniorrhaphy
Authors and Affiliations
Baviskar P, Vyas H. G, Kiran Koundinya
Keywords
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- EP ID EP284554
- DOI 10.14260/jemds/2018/43
- Views 57
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