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Comparison of prosthetic mesh repair and tissue repair in the emergency management of incarcerated para-umbilical hernia: a prospective randomized study

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Abstract

Background

Although prosthetic repair has become the gold standard for elective management of para-umbilical hernia (PUH) its use in the setting of acute incarceration is still limited for fear of prosthetic-related complications, mainly infection. The objective of this study was to compare results from prosthetic repair and tissue repair in the management of the acutely incarcerated PUH.

Patients and methods

Forty-two patients were prospectively randomized to either the prosthetic-repair group (group 1 = 21 patients) or the tissue-repair group (group 2 = 21 patients). In group 1, an onlay polypropylene mesh was inserted and the presence of non-viable intestine was not considered a contraindication for mesh repair. Operative time, postoperative hospital stay, and postoperative complications were recorded. Follow-up was performed by physical examination to detect recurrence.

Results

Mean operative time was significantly longer for group 1 (96.9 ± 14.6 compared with 65.5 ± 14.6 min for group 2, P < 0.05). Postoperative hospital stay did not differ significantly between the groups (3 ± 1.6 compared with 3.5 ± 2.2 days for groups 1 and 2, respectively). Postoperative complications did not differ significantly between the groups (28.6 vs. 23.8% for groups 1 and 2, respectively). No mesh had to be removed. At follow-up (mean 16 ± 5.5 months) there were four recurrences in group 2 (4/21, 19%) and no recurrences in group 1 (P < 0.05).

Conclusion

Use of prosthetic repair for emergency management of incarcerated PUH is safe and leads to superior results, in terms of recurrence, compared with conventional tissue repair. The presence of non-viable intestine cannot, furthermore, be regarded as a contraindication for prosthetic repair.

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Authors and Affiliations

  1. Department of General Surgery, Faculty of Medicine, University of Alexandria, Al-Azarita, Alexandria, Egypt

    N. A. Abdel-Baki, S. S. Bessa & A. H. Abdel-Razek

  2. 20 Ismail Serry St., Semouha, Alexandria, Egypt

    S. S. Bessa

Authors
  1. N. A. Abdel-Baki
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  2. S. S. Bessa
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  3. A. H. Abdel-Razek
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Correspondence to S. S. Bessa.

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Abdel-Baki, N.A., Bessa, S.S. & Abdel-Razek, A.H. Comparison of prosthetic mesh repair and tissue repair in the emergency management of incarcerated para-umbilical hernia: a prospective randomized study. Hernia 11, 163–167 (2007). https://doi.org/10.1007/s10029-007-0189-4

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  • DOI: https://doi.org/10.1007/s10029-007-0189-4

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