Pattern of abdominal wall hernia in Shisong, Cameroon

Abstract

Introduction: There is the obscurity of published data on surgical management of external abdominal wall hernias in our environment. This study was, therefore, to describe the pattern, outcome, and experience in the surgical management of anterior abdominal wall hernias in Shisong, Cameroon. Methods: This was a descriptive retrospective study conducted at St. Elizabeth Catholic General Hospital, Shisong. The various cases of abdominal wall hernias performed in the hospital during the study period of three years covering January 2017 to December 2019 by the surgical teams were included. We ensured that Ethical clearance and written informed consent were obtained before the start of the project. Information includes detailed sociodemographic data collected and analyzed by using SPSS 22 statistical software. Results: 465 cases of various abdominal wall hernias were included in this study. The most common type of hernia was indirect inguinal hernia (86.5%), and one rare Spigelian hernia was also there. The sub-arachnoid block was the most prevalent form of anesthesia. The various surgical procedures performed, including herniotomy (8.7%), hernioplasty (38.7%), and herniorrhaphy (28.6%), which were done for various inguinal hernias. In contrast, only mesh repair (9%) was performed for epigastric, lumbar, umbilical, Spigelian, and incisional hernia. Amongst the inguinal hernias, 55.2% were right-sided, 40.6% were left-sided, and 4.2% were bilateral, whereas 50% each of femoral hernia was left and right-sided. Overall, the annual recurrence rate for groin hernia was 1.9%. Conclusion: Inguinal Hernia was the most common type of hernia (86.3%). Among the inguinal hernia, the right side was more common (58.42%). The adoption of newer modalities of care should be considered standard. However, in resource-constrained settings like ours in Cameroon, the goal should be to perform a skillful and technically effective technique. Also, it is critical to ensure adequate anesthesia for optimal post-operative pain control, coupled with minimal morbidity.

Frequency of Abdominal Wall Hernias: A Nigerian Hospital Experience

“…Femoral hernia ranked a distant 6 th in the hierarchy of contribution to the hernia burden to 1.3% (12/902) of the cases. This is consistent with other reports from Zaria, Ibadan and Cameroon where it ranked 5 th [11], [16], [17]. This still reinforces the observation that femoral hernia is not the second most common type of abdominal wall hernia as stated in some surgical textbooks [2], [10].…”

“…Our results revealed a somewhat similar sequence: inguinal, umbilical, incisional, epigastric, paraumbilical, femoral and others. This compares to the pattern from a study carried out in Cameroon [11]. Inguinal hernias accounted for 72.9% of all our hernia operations which is comparable to the 75% mentioned in several series, but still lower than the 86.3% mentioned in the same study from Cameroon.…”

“…Incisional hernia repair came third in our study. While this tallies with the findings from Zaria, incisional hernia was the second most common grouping from the work in Ibadan and Cameroon [11], [16], [17]. Abur et al rationalized that the numbers for incisional hernia may have been higher because of the higher literacy rate in the Ibadan metropolis, which may lead to an increased tendency to accept surgery.…”