Feasibility and Safety of Prosthetic Implants for Inguinal Hernia Repair in a Nigerian Tertiary Hospital

Ogbuanya, Aloysius Ugwu‐Olisa; Olisa, Fabian Ugonna; Oguonu, Amobi; Ugwu, Nonyelum Benedett

doi:10.55320/mjz.47.3.702

MJZ

2020

DOI: 10.55320/mjz.47.3.702

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Feasibility and Safety of Prosthetic Implants for Inguinal Hernia Repair in a Nigerian Tertiary Hospital

Aloysius Ugwu‐Olisa Ogbuanya

Fabian Ugonna Olisa

Amobi Oguonu³

et al.

Abstract: Background: Worldwide, inguinal hernia repair is the commonest surgical procedure in general surgery, but the optimal repair technique for inguinal hernia has not been defined and accepted in most parts of Africa and other developing nations. The aim of this study was to determine the epidemiology of inguinal hernias and feasibility of mesh implants in our centre. Methodology: This was a descriptive cross-sectional study of consecutive adult patients with uncomplicated inguinal hernias who received polyp… Show more

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Cited by 2 publications

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Epidemiology and treatment of groin and ventral hernias in the Zinder region, Niger Republic

Adamou¹,

Magagi²,

Habou³

et al. 2023

International Journal of Abdominal Wall and Hernia Surgery

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OBJECTIVE: To describe epidemiological, therapeutic, and prognostic aspects of groin and ventral hernia in adults at Zinder National Hospital. MATERIALS AND METHODS: This was a retrospective data collected over a period of 10 years (January 2012–December 2021). All patients aged at least 18 years operated for abdominal wall hernia were included. A value of P < 0.05 was considered significant. RESULTS: A total of 921 patients were included. In these patients, groin hernia was present in 78.8% (n = 726), umbilical hernia in 13.25% (n = 122), linea alba hernia in 7.3% (n = 67), and Spiegel’s hernia in 6 cases (0.65%). The mean age was 48 ± 17.2 years. Men accounted for 80.9% (n = 745). Rural origin was 67% (n = 623) and poor 63.8% (n = 588). The stage of hernia strangulation represents 32% (n = 295). The median time to surgical consultation was 8 years. This delay was associated with rural origin (odds ratio [OR] = 1.42; P = 0.0142), poverty status (OR = 1.67; P = 0.0001), and inguinal location (OR = 1.75; 0.0371). General anesthesia was used in 58.7% (n = 541). Bowel necrosis was seen in 9.33% (n = 86). For all groin hernias (n = 783), 96.2% (n = 753) underwent herniorrhaphy and 3.8% (n = 30) underwent a Lichtenstein procedure. For all ventral hernias herniorrhaphy was performed in 95% (n = 245) and mesh repair in 5% (n = 13). Morbidity was 15.4% (n = 142) and mortality 1.74% (n = 16). This was associated with age over 60 years (OR = 3.06; P = 0.0341), ASAIII and ASAIV classes (OR = 5.21; P = 0.015), complicated clinical forms (OR = 4.87; P = 0.023), emergency surgery (OR = 4.51; P = 0.003), and the occurrence of bowel necrosis (OR = 4.11; P = 0.001). The median follow-up was 6 months (range: 3–36 months). Overall, hernia recurrence was recorded in 69 cases or 7.6%. This was associated with emergency surgery (OR = 6.26; P = 0.000) and age over 60 years (OR = 3.02; P = 0.000). CONCLUSION: In our context, the management of groin and ventral hernias is an important activity for the surgeon. Inguinal hernias predominate and hernia strangulation is an element of poor prognosis.

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Epidemiology and treatment of groin and ventral hernias in the Zinder region, Niger Republic

Adamou¹,

Magagi²,

Habou³

et al. 2023

International Journal of Abdominal Wall and Hernia Surgery

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Surgical repair of abdominal wall hernias in rural southeast Nigeria

Ogbuanya¹,

NB²

2022

International Journal of Abdominal Wall and Hernia Surgery

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Background: Abdominal wall hernias constitute a significant cause of morbidity and mortality globally, but more importantly, they present a more pathetic situation in rural areas of sub-Saharan Africa and other developing nations. In our setting, the rate of elective repair is still too low and many cases present late, often with complications. This study aimed at documenting the spectrum, barriers to early repair, and factors that influence the outcomes of repair. Materials and Methods: A prospective study of adult patients surgically treated for abdominal wall hernia in rural southeast Nigeria between January 2014 and December 2019. Results: Overall, 975 patients were recruited: 706 (72.4%) had simple uncomplicated hernias, whereas the rest (269, 27.6%) presented in the emergency. Inguinal hernias comprised 74.1% of the cases followed by primary midline hernias (14.5%). Delayed presentation was common, with only 2.3% presenting within three months and the main reason being financial constraint (31.0%) followed by ignorance (12.2%). A third (324, 33.2%) of the patients harbored complete inguinoscrotal/inguinolabial hernias. Nearly a quarter (240, 24.6%) had comorbid illnesses, 14.9% harbored recurrent hernias, and more than a third (43.4%) had hernias with defect sizes >5 cm. Wound infection rates were 34.6% in the emergency group, 26.2% in the elderly, 20.7% for those with recurrent hernias, and 17.1% in those with comorbidities. Morbidity rates were greater in patients with hernia defects >10 cm (37.8%), inguinoscrotal/inguinolabial hernias (18.5%), and those who received bowel resection (56.7%). Generally, elevated wound infection and high overall morbidity rates were associated with emergency presentation (P = 0.000), advancing age (P = 0.030), procedures performed by a nonspecialist surgeon (P = 0.014), and large hernia variants (P = 0.000). Overall, mortality rate was 2.9%, but it was 9.7% in those with emergency repair. The main independent predictors of mortality were intestinal resection (P = 0.000), delayed presentation (0.003), advanced age (0.020), and comorbidities (P = 0.002). Conclusion: Delayed presentation, often in an emergency setup, is common among patients with abdominal wall hernias in our rural practice. Financial impediments and ignorance were the main barriers to early presentation and elective repair. Consequently, morbidity and mortality rates were high, especially in the setting of advancing age, delayed presentation, coexisting medical conditions, and bowel resection.

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Feasibility and Safety of Prosthetic Implants for Inguinal Hernia Repair in a Nigerian Tertiary Hospital

Cited by 2 publications

References 8 publications

Epidemiology and treatment of groin and ventral hernias in the Zinder region, Niger Republic

Epidemiology and treatment of groin and ventral hernias in the Zinder region, Niger Republic

Surgical repair of abdominal wall hernias in rural southeast Nigeria

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