Repair of incisional hernias

Citation
Hs. Khaira et al., Repair of incisional hernias, J ROY COL S, 46(1), 2001, pp. 39-43
Citations number
24
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Surgery
Journal title
JOURNAL OF THE ROYAL COLLEGE OF SURGEONS OF EDINBURGH
ISSN journal
0035-8835 → ACNP
Volume
46
Issue
1
Year of publication
2001
Pages
39 - 43
Database
ISI
SICI code
0035-8835(200102)46:1<39:ROIH>2.0.ZU;2-1
Abstract
Incisional hernias develop in up to 11% of surgical abdominal wounds with a possible recurrence following repair of 44%, We describe our experience wi th a combined fascial and prosthetic mesh repair. Thirty-five patients (16M :19F) have been treated. The original operation was bowel related in 19 cas es, gynaecological in 8, hepatopancreaticobiliary in 3 patients, aortic ane urysm repair in 2 and involved a thoraco-laparotomy in 3, The incisions wer e midline in 26 cases, transverse in 6, paramedian in 2 and rooftop in one patient. The hernias were considered subjectively to be large in 15, medium in 14 and small in 6 of the patients. A proforma was completed for each pa tient noting intra-operative and post-operative complications, post-operati ve hospital stay and analgesic requirements. Post-operative complications i ncluded seroma formation in 6 patients, deep vein thrombosis in one and a n on-fatal pulmonary embolism in another. One patient developed a wound haema toma and one had a superficial wound infection. Post-operative in-hospital stay ranged from 1 to 27 days with a mean of 6.2 days, Of the 35 patients 3 3 were available for follow-up. Follow-up was for a median of 20.3 months ( range 6.0 to 54.1 months). Two of these (6%) patients reported a persistent lump and one (3%) reported persistent pain but none of the remaining 33 wa s found to have a recurrence. We advocate this technique because it is appl icable to all hernias, most of the mesh is behind the rectus sheath and has 2 points of fixation, it is relatively pain-free allowing early mobilisati on, has a modest complication rate and a low recurrence rate.