Retrospective comparison of mesh and sutured repair for adult umbilical hernias

Abstract

Adult umbilical and paraumbilical hernia repair is associated with a high recurrence rate of 10-30%. Mesh repair has been reported to be associated with low recurrence rates. This study aims to compare sutured repair with prosthetic mesh repair to evaluate recurrence and infection rates. A retrospective study was conducted over an 8-year period including all the umbilical and paraumbilical hernia repairs performed by one consultant surgeon. The hernias were repaired using interrupted suture, Mayo overlap, flat mesh and mesh plug techniques. The study was based on case-note review, telephone and postal questionnaire survey. A total of 100 patients were studied, of which 70 had paraumbilical hernias, 28 had umbilical hernias and 2 had both types of hernia. Median age was 56 years (range 19-90 years). A total of 61 patients had suture repair (50 interrupted suture repair, 11 Mayo) and 39 had prosthetic mesh repair (33 mesh plug, 6 flat mesh). The median body mass index (BMI) was 31.2 (range 23.4-44.5) in the suture repair group and 33.3 (range 24.1-59.1) in the mesh group, with no significant statistical difference in BMI between the two groups (P>0.05). Median follow-up was 4.5 years (range 1-8 years). Recurrence rates for the suture and mesh repair groups were 11.5 and 0%, respectively (P=0.007). Infection rates for the suture and mesh repair groups were 11.5 and 0%, respectively (P=0.007). Our data suggest that prosthetic mesh repair is ideal for managing primary and recurrent umbilical hernias in both obese and non-obese patients.

Incarcerated abdominal wall hernia surgery: relationship between risk factors and morbidity and mortality rates (a single center emergency surgery experience)

“…Surgical repair using mesh is the current trend in the treatment of primary or recurrent umbilical hernias in both obese and non-obese adults due to its lower recurrence rate as compared to surgical repair by suturing (1% vs. 11%). [32,33] In conclusion, the present study demonstrated that advanced age (≥65 years), presence of concomitant disease, intestinal strangulation, necrosis and intestinal resection, high ASA score (III-IV), and time from onset of the symptoms were effective on morbidity and mortality. General anesthesia poses a risk for morbidity as well.…”

Mesh Repair In Adult Para Umbilical Hernias - A Comparative Study between Open Mayo’s Repair and Tension Free Onlay Prosthetic

“…[8][9][10] Recurrence is less seen in Mesh repair which is also evident from our study. [9][10][11][12] The mean surgical time is basically determined by the size of hernia and intraperitoneal adhesion formation and not essentially by the methods of reconstruction. [6,[13][14][15] We confirmed these observations when we found numerous difference between two groups (group 'A' and group 'B'), but there was no significant differences between the types of reconstructions inside these groups.…”

Análisis prospectivo de hernioplastías umbilicales en adultos

“…Cuando los índices de recidiva de ésta téc-nica son comparados con los de técnicas protésicas se observa que son significativamente más altos, no superando el 2% en éstas últimas 1,2,4 . Otros trabajos retrospectivos que comparan herniorrafias con hernioplastías informan 0% de recidivas con la utilización de mallas 14 .…”