Epidemiology and management of ventral hernia in a tertiary health care centre- a prospective observational study
DOI:
https://doi.org/10.18203/2349-2902.isj20220331Keywords:
Ventral hernias, Surgical management, Postoperative complicationsAbstract
Background: Ventral hernias are a common problem confronting surgeons. Data about standards of their surgical management have failed to keep pace with rapid advances in surgical techniques, and materials. Older techniques have often been discarded simply because of availability of newer ones without due consideration to availability, feasibility, training, local conditions and constraints. Therefore, a balanced, practical and pragmatic opinion regarding surgical management at individual, institutional and regional levels is needed. We studied clinical aspects and best treatment modalities of ventral hernias in our set-up.
Methods: This is a prospective observational study of various types of ventral hernias, surgically managed at a tertiary care hospital between January 2018 and September 2019.
Results: Mean age of presentation among 71 patients (27 males, 44 females) was 48.11±5.71 years. Incisional hernias (30.98%) were the commonest type. Painless swelling (49.29%) was the most common clinical presentation. Obesity (40.84%) and multiparity (30.98%) were the most common associated risk factors. Incisional hernias are probably better managed by open approach.
Conclusions: Ventral hernias are more prevalent in the elderly and females. Incisional, umbilical, epigastric hernias are the more common types. Laparoscopy is being preferred over open procedure due to some advantages that it offers, but incisional hernias can often be better managed by open approach depending upon local set up. In addition, laparoscopic approach is not universally applicable and also has certain drawbacks.
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References
Muysoms FE, Miserez M, Berrevoet F. Classification of primary and incisional abdominal wall hernia. Hernia. 2009;13:407-14.
Mudge M, Hughes LE. Incisional hernia: a 10-year prospective study of incidence and attitudes. Br J Surg. 1985;72(1):70-1.
Perrone JM, Soper NJ, Eagon JC, Klingensmith ME, Aft RL, Frisella MM, et al. Perioperative outcomes and complications of laparoscopic ventral hernia repair. Surgery. 2005;138:708-15.
Helgstrand F , Rosenberg J, Kehlet H, Jorgensen LN, Wara P, Bisgaard T. Risk of morbidity, mortality, and recurrence after parastomal hernia repair: a nationwide study. Dis Colon Rectum. 2013;56:1265-72.
Rucinski J, Margilis M, Panagopoulos G, Wise L. Closure of the abdominal midline fascia: Meta analysis delineates the optimal technique. Am Surg. 2001;67:421-6.
Jaykar RD, Varudkar AS, Akamanchi AK. A clinical study of ventral hernia. Int Surg J. 2017;4(7):2326-9.
Alenazi AMA, Alsharif MM, Hussain MA, Alenezi NG, Alenazi AA, Almadani SA, et al. Prevalence, risk factors and character of abdominal hernia in Arar City, Northern Saudi Arabia in 2017. Electronic Physician. 2017;9(7):4806-11.
Sharath JG, Upendra KK, Manangi M, Madhu KP, Arun BJ, Nagaraj N. Incisional hernia: incidence, clinical profile, risk factors and prevention. Int Surg J. 2016;3(3):1292-5.
Carlson MA, Ludwig KA, Condon RE. Ventral hernia and other complications of 1,000 midline laparotomies. South Med J. 1995;88(4):450-9.
Jawale PG, Chaudhari Y. Prevalence of paraumbilical hernia and outcome at surgery inpatient department: A hospital based study. MedPulse – Int Med J. 2015;2(11):775-7.
Bucknall TE. The effect of local infection upon wound healing- an experimental study. Br J Surg. 1980;67:851-5.
Bose SM, Lal R, Kalra M, Wig JD, Khanna SK. Ventral hernia–A review of 175 cases. Indian J Surg. 1999;61(3):180-4.
Rubby SA, Rangaswamy P, Sundar P. A prospective study comparing laparoscopic and open ventral hernia repair. Int Surg J. 2017;4(1):170-6.
Millikan KW. Incisional hernia repair. Surg Clin North Am. 2003;83:1223-34.