Cone mesh repair in paraumbilical hernia in comparison with Mayo's repair

ABSTRACT

This study was designed to assess and evaluate the recent method of tension free prosthetic mesh plug hernioplasty and comparing it with the old method of tension repair "Mayo's repair' in cases of paraumbilical hernias. The present study included 60 patients presented with clinical diagnosis of midline aponeunotic hernia, during the period from April 2007 to April 2009, selected from Al-Azhar University Hospital at Damietta. All included cases were submitted to full history taking and thorough clinical examination. Routine laboratory investigations were carried out. There was a statistically significant decrease in operative time hospitalization time and number of drains I in group 2 [Mesh repair] in comparison to group 1 [Mayo's repair] [47.33 +/- 6.26, 1.33 +/- 0.54 and 6.7% vs 76.20 +/- 9.60, 2.76 +/- 0.50 and 83.3% respectively]. Early complications were in the form of seroma in 6.7%, hematoma in 1.7%, superficial wound infection in 6.7%, persistent wound pan in 3.3% and respiratory complications in 1.7%, while late complications were in the form of chronic wound pain in 5%, recurrence in 6.7% and patient unsatisfaction in 11.7% . There were statistically signficant decreases in late complications in group 2 [Mesh repair] in comparison to group 1 [Mayo's repair], while this difference was statistically non-signficant as regard early complications. Mesh plug hernioplasty has a good outcome compared to Mayo's repair. So, the mesh plug hernioplasty seems to be the logic major improvement in the management of these cases that formerly has a high recurrence rate and thus it is recommended to replace the Mayo's repair, in cases of mid-aponeunotic hernias specially that of a small defect of few centimeters