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Abstract
ABSTRACT
Introduction. Hernia management is largely neglected as a public health priority in developing countries where herniorraphy with suture line tension is commonly used, especially in peripheral zones. This study aimed to evaluate the treatment of hernias in a peripheral area of Cameroon. Patients and methods. A descriptive 14-months study was carried out from January 2019 to February 2020, at the general surgical Service of the Yokadouma District Hospital. Demographic data, clinical presentation, surgical data, and 30-day postoperative outcomes were collected. Results. Seventy-three (73) patients (86.9%) were men, 58 patients (69%) were farmers and the average age was 50 years (extremes 25 and 75 years). Inguinal hernia was found in 58 patients (69%) and 17 patients (20.2%) presented with strangulated hernia. Ninety-one (91) surgical procedures were performed in the 76 patients with groin hernia, including 48 suturing (52.7%) and 43 Lichtenstein procedures (47.3%). The patients with other types of parietal hernias received only suturing procedures. The postoperative morbidity was 4.8% and no death was found postoperatively. Conclusion. Many technics are used for hernia repair in Yokadouma District Hospital, with suturing procedures being the most administered. However, Lichtenstein's technique is widely used. Postoperative morbidity and mortality are low.
RÉSUMÉ
Introduction. Le traitement des hernies est largement négligé en tant que priorité de santé publique dans les pays en développement où les herniorraphies sont couramment utilisées, notamment en zone périphériques. Cette étude avait pour objectif d’évaluer le traitement des hernies dans une zone périphérique du Cameroun. Méthodologie. Une étude descriptive d'une durée de 14 mois avait été réalisée de janvier 2019 à février 2020, au service de chirurgie générale de l'Hôpital de District de Yokadouma. Les données démographiques, la présentation clinique, les données chirurgicales et les résultats postopératoires à 30 jours ont été collectés. Résultats. Soixante-treize (73) patients (86,9 %) étaient des hommes, 58 patients (69 %) étaient des agriculteurs et l'âge moyen était de 50 ans (extrêmes 25 et 75 ans). Une hernie inguinale était retrouvée chez 58 patients (69 %) et 17 patients (20,2 %) présentaient une hernie étranglée. Quatre-vingt-onze (91) interventions chirurgicales ont été réalisées chez les 76 patients présentant une hernie inguinale, dont 48 herniorraphies (52,7 %) et 43 interventions de Lichtenstein (47,3 %). Les patients présentant d’autres types de hernies pariétales n’ont reçu que des procédures de suture. La morbidité postopératoire était de 4,8 % et aucun décès n'a été constaté en postopératoire. Conclusion. De nombreuses techniques sont utilisées pour le traitement des hernies à l'Hôpital de District de Yokadouma, les herniorraphies étant les plus pratiquées. Cependant, la technique de Lichtenstein est largement utilisée. La morbidité et la mortalité postopératoires sont faibles.
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References
- Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. Lancet. 2003 ;362 :1561-1571.
- Ohene-Yeboah M, Abantanga FA. Inguinal hernia disease in Africa: a common but neglected surgical condition. West Afr J Med. 2011 ;30 :77-83.
- Kingsnorth AN, Clarke MG, Shillcutt SD. Public health and policy issues of hernia surgery in Africa. World J Surg. 2009; 33:1188.
- Sanders DL, Porter CS, Mitchell KD, Kingsnorth AN. A prospective cohort study comparing the African and European hernia. Hernia. 2008 ;12 :527-529.
- Patel HD, Groen RS, Kamara TB et al. An estimate of hernia prevalence in Sierra Leone from a nationwide community survey. Hernia. 2014 ;18 :297-303.
- Yordanov YS, Stoyanov SK. The incidence of hernia on the island of Pemba. East Afr Med J. 1969 ;46 :687-691.
- Maine RG, Linden AF, Riviello R et al. Prevalence of untreated surgical conditions in rural Rwanda: a population-based cross-sectional study in Burera district. JAMA Surg. 2017 ;152 : e174013.
- Grimes CE, Law RS, Borgstein ES et al. Systematic review of met and unmet need of surgical disease in rural sub-Saharan Africa. World J Surg. 2012 ;36 :8-23.
- Löfgren J, Makumbi F, Galiwango E et al. Prevalence of treated and untreated groin hernia in eastern Uganda. Br J Surg. 2014 ;101 :728-734.
- Yang J, Papandria D, Rhee D et al. Low-cost mesh for inguinal hernia repair in resource-limited settings. Hernia. 2011 ;15 :485-489.
- Carbonell JF, Sanchez JL, Peris RT, Ivorra JC, Del Baño MJ, Sanchez CS, Arraez JI, Greus PC. Risk factors associated with inguinal hernias: a case control study. Eur J Surg. 1993 Sep ;159(9) :481-6. PMID : 8274556.
- Dossouvi T, Kanassoua KK, Kassegne I et al. Prise en charge des hernies de l’aine au Chu-Kara (Togo). European Scientific Journal 2021 ;17(21) :256-64.
- Montcho Hodonou A, Tamou Sambo B, Gandaho IE et al. Caractéristiques Epidémiologiques Et Thérapeutiques Des Hernies Pariétales Au Centre Hospitalier Universitaire Du Borgou A Parakou, Bénin. WWJMRD. 2018 ;4(5):43-46.
- Mabula JB, Chalya PL. Surgical management of inguinal hernias at Bugando Medical Centre in northwestern Tanzania: our experiences in a resource-limited setting. BMC Res Notes 2012; 5:585.
- Arowolo OA, Agbakwuru EA, Adisa AO et al. Evaluation of tension-free mesh inguinal hernia repair in Nigeria: a preliminary report. West Afr J Med 2011 ;30(2) :110-3.
- Clarke MG, Oppong C, Simmermacher R et al. The use of sterilised polyester mosquito net mesh for inguinal hernia repair in Ghana. Hernia 2009 ;13(2) :155-9.
- Bourgouin S, Goudard Y, Montcriol A et al. Feasibility and limits of inguinal hernia repair under local anaesthesia in a limited resource environment: a prospective controlled study. Hernia 2017 ;21(5) :749-57.
- Olaogun JG, Afolayan JM, Areo PO et al. Repair of groin hernia under local anaesthesia in secondary health facility. ANZ J Surg 2018;88(4):294-7.
- Traoré D, Diarra L, Coulibaly B. Hernie inguinale en Afrique subsaharienne : quelle place pour la technique de Shouldice? Pan Afr Med J. 2015 ;22 :50.
- Simons MP, Aufenacker T, Bay-Nielsen M et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 2009; 13:343-403.
- The HerniaSurge. Group International guidelines for groin hernia management. 2018 ;22 :1-165.
- Rouet J, Bwelle G, Cauchy F et al. Polyester mosquito net mesh for inguinal hernia repair: a feasible option in resource limited settings in Cameroon? J Visc Surg 2018 ;155(2):111-6.
- Diop B, Sall I, Sow O et al. Prise en charge des hernies inguinales par prothèse selon la procédure de Lichtenstein: une étude de 267 cas. Health Sci Dis 2018 ;19(1):69-73.
- Beard JH, Ohene-Yeboah M, Tabiri S et al. Outcomes after inguinal hernia repair with mesh performed by medical doctors and surgeons in Ghana. JAMA Surg 2019;154(9):853-9.
- Dieng M, El Kouzi B, Ka O et al. Les hernies étranglées de l’aine de l’adulte : une série de 228 observations. Mali Med 2008 ;23(1):12-6.
References
Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. Lancet. 2003 ;362 :1561-1571.
Ohene-Yeboah M, Abantanga FA. Inguinal hernia disease in Africa: a common but neglected surgical condition. West Afr J Med. 2011 ;30 :77-83.
Kingsnorth AN, Clarke MG, Shillcutt SD. Public health and policy issues of hernia surgery in Africa. World J Surg. 2009; 33:1188.
Sanders DL, Porter CS, Mitchell KD, Kingsnorth AN. A prospective cohort study comparing the African and European hernia. Hernia. 2008 ;12 :527-529.
Patel HD, Groen RS, Kamara TB et al. An estimate of hernia prevalence in Sierra Leone from a nationwide community survey. Hernia. 2014 ;18 :297-303.
Yordanov YS, Stoyanov SK. The incidence of hernia on the island of Pemba. East Afr Med J. 1969 ;46 :687-691.
Maine RG, Linden AF, Riviello R et al. Prevalence of untreated surgical conditions in rural Rwanda: a population-based cross-sectional study in Burera district. JAMA Surg. 2017 ;152 : e174013.
Grimes CE, Law RS, Borgstein ES et al. Systematic review of met and unmet need of surgical disease in rural sub-Saharan Africa. World J Surg. 2012 ;36 :8-23.
Löfgren J, Makumbi F, Galiwango E et al. Prevalence of treated and untreated groin hernia in eastern Uganda. Br J Surg. 2014 ;101 :728-734.
Yang J, Papandria D, Rhee D et al. Low-cost mesh for inguinal hernia repair in resource-limited settings. Hernia. 2011 ;15 :485-489.
Carbonell JF, Sanchez JL, Peris RT, Ivorra JC, Del Baño MJ, Sanchez CS, Arraez JI, Greus PC. Risk factors associated with inguinal hernias: a case control study. Eur J Surg. 1993 Sep ;159(9) :481-6. PMID : 8274556.
Dossouvi T, Kanassoua KK, Kassegne I et al. Prise en charge des hernies de l’aine au Chu-Kara (Togo). European Scientific Journal 2021 ;17(21) :256-64.
Montcho Hodonou A, Tamou Sambo B, Gandaho IE et al. Caractéristiques Epidémiologiques Et Thérapeutiques Des Hernies Pariétales Au Centre Hospitalier Universitaire Du Borgou A Parakou, Bénin. WWJMRD. 2018 ;4(5):43-46.
Mabula JB, Chalya PL. Surgical management of inguinal hernias at Bugando Medical Centre in northwestern Tanzania: our experiences in a resource-limited setting. BMC Res Notes 2012; 5:585.
Arowolo OA, Agbakwuru EA, Adisa AO et al. Evaluation of tension-free mesh inguinal hernia repair in Nigeria: a preliminary report. West Afr J Med 2011 ;30(2) :110-3.
Clarke MG, Oppong C, Simmermacher R et al. The use of sterilised polyester mosquito net mesh for inguinal hernia repair in Ghana. Hernia 2009 ;13(2) :155-9.
Bourgouin S, Goudard Y, Montcriol A et al. Feasibility and limits of inguinal hernia repair under local anaesthesia in a limited resource environment: a prospective controlled study. Hernia 2017 ;21(5) :749-57.
Olaogun JG, Afolayan JM, Areo PO et al. Repair of groin hernia under local anaesthesia in secondary health facility. ANZ J Surg 2018;88(4):294-7.
Traoré D, Diarra L, Coulibaly B. Hernie inguinale en Afrique subsaharienne : quelle place pour la technique de Shouldice? Pan Afr Med J. 2015 ;22 :50.
Simons MP, Aufenacker T, Bay-Nielsen M et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 2009; 13:343-403.
The HerniaSurge. Group International guidelines for groin hernia management. 2018 ;22 :1-165.
Rouet J, Bwelle G, Cauchy F et al. Polyester mosquito net mesh for inguinal hernia repair: a feasible option in resource limited settings in Cameroon? J Visc Surg 2018 ;155(2):111-6.
Diop B, Sall I, Sow O et al. Prise en charge des hernies inguinales par prothèse selon la procédure de Lichtenstein: une étude de 267 cas. Health Sci Dis 2018 ;19(1):69-73.
Beard JH, Ohene-Yeboah M, Tabiri S et al. Outcomes after inguinal hernia repair with mesh performed by medical doctors and surgeons in Ghana. JAMA Surg 2019;154(9):853-9.
Dieng M, El Kouzi B, Ka O et al. Les hernies étranglées de l’aine de l’adulte : une série de 228 observations. Mali Med 2008 ;23(1):12-6.