Mesh versus suture repair of primary inguinal hernia in Ghana
| Autor: | Omar Omar, Dmitri Nepogodiev, A. Moten, Stephen Tabiri, F. Atindaana Abantanga, F. Owusu, Aneel Bhangu |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty lcsh:Surgery Hernia Inguinal Ghana Primary outcome Suture (anatomy) Recurrence Outcome Assessment Health Care Medicine Humans Prospective Studies General Sutures business.industry lcsh:RD1-811 General Medicine Odds ratio Original Articles Middle Aged Surgical Mesh medicine.disease Confidence interval Surgery Inguinal hernia Increased risk Surgical mesh Hernia recurrence Original Article business Follow-Up Studies |
| Zdroj: | BJS Open BJS Open, Vol 3, Iss 5, Pp 629-633 (2019) |
| ISSN: | 2474-9842 |
| Popis: | Background Most patients in Ghana undergo suture repair for primary inguinal hernia. Although there is strong evidence from high‐income country settings to indicate superiority of mesh repair for inguinal hernia, the evidence to support the safety and effectiveness of mesh repair in the Ghanaian setting is limited. This study aimed to compare hernia recurrence rates following suture versus mesh repair in Ghana. Methods Men aged 18 years or over presenting with symptomatic, reducible inguinal hernias were included. Over the first 6 months all consecutive patients were enrolled prospectively and underwent a standardized suture repair; an equal number of patients were subsequently enrolled to undergo mesh repair. The primary outcome was hernia recurrence within 3 years of the index operation. Multivariable analysis was adjusted for age and right or left side. Adjusted odds ratios (ORs) with 95 per cent confidence intervals are reported. Results A total of 116 sutured and 116 mesh inguinal hernia repairs were performed. Three years after surgery, follow‐up data were available for 206 of the 232 patients (88·8 per cent). Recurrence occurred significantly more frequently in the suture repair group (23 of 103, 22·3 per cent) than in the mesh group (7 of 103, 6·8 per cent) (P = 0·002). In multivariable analysis, suture repair was independently associated with an increased risk of recurrence (OR 4·51, 95 per cent c.i. 1·76 to 11·52; P = 0·002). Conclusion In Ghana, mesh inguinal hernia repair was associated with reduced 3‐year recurrence compared with sutured repair. Controlled dissemination across Ghana should now be assessed. |
| Databáze: | OpenAIRE |
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