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Management of midline ventral hernias in a surgical department of sub-Saharan Africa: A retrospective cohort study

2022; Wolters Kluwer; Volume: 78; Linguagem: Inglês

10.1016/j.amsu.2022.103801

2049-0801

Abdourahmane Ndong, Jacques Noël Tendeng, Guillaume Tcheutchoua Soh, Adja Coumba Diallo, Mohamed Lamine Diao, Ndiamé Sarr, Ibrahima Bodian, Ibrahima Diarra, Philippe Manyacka Ma Nyemb, Ibrahima Konaté,

Appendicitis Diagnosis and Management

The linea alba is the second most frequent site of abdominal wall hernias after the inguinal region. Prosthetic approach, often recommended, comes up against the low socio-economic level and the availability of these materials in developing countries. Our objective is to evaluate the indications and results of midline ventral hernia surgery.This was a retrospective cross-sectional study over 36 months including all adult patients (over 15 years old) treated for primary or recurrent midline ventral hernias. The parameters studied were: age, sex, risk factors, type of hernia according to the classification of the European Hernia Society (EHS), clinical presentation, hernial ring size, surgical technique and results (recurrence, chronic pain).We included 65 patients. The mean age was 40.5 years ± 16.4. There was a female predominance (56.3%, n = 36) with a sex ratio of 0.77. According to the EHS classification, type M3 (umbilical) was more common (67.2%), followed by type M2 (epigastric) in 25% and M4 (infra-umbilical) in 1.6%. According to the clinical presentation, 85.6% (n = 55) were uncomplicated, 10.9% (n = 7) were strangulated in and 3.1% (n = 2) incarcerated. A primary suture was performed in 93.8% (n = 61) and a mesh repair in 6.15% (n = 4). With a mean follow-up of 8.2 ± 11.9 months, we noted a recurrence in 6.1% (n = 4) and chronic pain in 6.1% (n = 4).There is a need to individualize or contextualize the guidelines. In our context where meshes are not always available, pure tissue repairs keep their place in the treatment.