Randomized clinical trial comparing suture and mesh repair of umbilical hernia in adults

Author:

Arroyo A1,García P1,Pérez F1,Andreu J1,Candela F1,Calpena R1

Affiliation:

1. Ambulatory Surgery Unit, Department of Surgery, University Hospital of Elche, Elche, Spain

Abstract

Abstract Background Prosthetic repair has become the standard method for inguinal hernia and has excellent results. The question remains of whether the mesh technique could also improve results for umbilical defects. Methods The study was a randomized clinical trial comparing herniorrhaphy (primary suture) with hernioplasty (polypropylene mesh or plug) in 200 adult patients with a primary umbilical hernia. Patients at high anaesthetic risk (American Society of Anesthesiologists (ASA) grade IV) or those who needed emergency surgery were excluded. The mean postoperative follow-up was 64 months. The population studied included 118 women and 82 men with a mean age at presentation of 57 years. Some 173 patients were ASA grade I–II and 27 were ASA III. The anaesthetic technique of choice was local anaesthetic infiltration plus sedation (98 per cent). Results There were no significant anaesthetic complications or surgical deaths. The mean duration of surgery was greater for mesh than for suture repair (45 versus 38 min). Rates of early complications such as seroma, haematoma or wound infection were similar in the two groups. The hernia recurrence rate was higher after suture repair (11 per cent) than after mesh repair (1 per cent) (P = 0·0015). Conclusion Prosthetic repair could become the standard treatment for primary umbilical hernia in adults.

Publisher

Oxford University Press (OUP)

Subject

Surgery

Reference14 articles.

1. Hernias de la pared abdominal. Estudio multicéntrico epidemiológico (1993–1994);Hidalgo;Cirugia Española,1996

2. Mesh plug hernia repair: a follow-up report;Rutkow;Surgery,1995

3. The tension-free hernioplasty;Lichtenstein;Am J Surg,1989

4. Prophylactic umbilical hernia repair in childhood to prevent adult incarceration;Morgan;Surg Clin North Am,1970

5. Hernia umbilical del adulto. Resultados a largo plazo en pacientes operados de urgencia;García Ureña;Cirugia Española,1994

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