Comparison of prosthetic mesh repair and tissue repair in the emergency management of incarcerated para-umbilical hernia.

Abstract

Objective: To compare the outcomes of prosthetic repair and tissue repair in the emergency management of acutely incarcerated para-umbilical hernia (PUH). Study Design: Randomized Clinical Trial. Setting: Department of Surgery, DHQ Hospital KDA Kohat, Pakistan. Period: July 2021 to December 2022. Material & Methods: A total of 40 patients (20 in each group) of either gender aged above 18 years with acutely incarcerated PUH undergoing emergency management were randomized in to either mesh repair or tissue repair. The length of the procedure, the hospital stay following the procedure, and any postoperative issues were noted up till 6 months post-operatively. Results: In a total of 40 patients, 35 (87.5%) were female. The difference in the mean operating times for prosthetic repair group and tissue repair group were significantly different (97.2±15.2 minutes vs. 66.2±15.2 minutes, p<0.0001). Duration of incarceration and characteristics of the defect were statistically similar (p>0.05). Postoperative complications were encountered in 6 (30.0%) patients in prosthetic repair groups versus (25.0%) in tissue repair groups while the difference between various complications were found to be statistically insignificant (p>0.05). Throughout the course of the trial, there were no permanent difficulties caused by the mesh and none of the mesh had to be taken out. Conclusion: The use of prosthetic repair for emergency management of incarcerated PUH was safer and resulted in better outcomes as compared to conventional tissue repair.