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Abstract
RÉSUMÉ
Objectif. Rapporter notre expérience dans la prise en charge des hernies inguinales par Prothèse selon la procédure de Lichtenstein. Population et méthodes. Nous avons réalisé une étude rétrospective transversale, descriptive de juin 2018 à mai 2021 dans le service de la chirurgie digestive du CHU de Brazzaville. Elle a porté sur les patients suivis pour des hernies inguinales et opérés selon la technique de Lichtenstein. Nos paramètres d’intérêt étaient épidémiologiques, diagnostiques, thérapeutiques et évolutifs. Le type de la hernie était classé selon NYHUS. Résultats. Les hernies opérées selon Lichtenstein ont représenté 43,12% de toutes les hernies inguinales. 116 patients ont été retenus dont 106 hommes (91,38%). L’âge moyen des patients étaient de 45,83±19,67 ans avec des extrêmes de 17 et 90 ans. 64,66% des patients avaient un facteur herniogène. La tuméfaction (100%) et la douleur (54,31%) ont été les principaux motifs de consultation. Il y avait 65cas de hernie inguinale (52%) et 60 cas de hernie inguinoscrotale. 93,96% de malades étaient opérés au programme et 6,04% en urgence. Dans 73,60% des cas, l’abord était transversal. Les hernies de type IIIB de NYHUS représentaient 47,2%. La cure a été faite dans tous les cas avec le polypropylène prédécoupée de 11 × 6 Cm. Les suites opératoires immédiates ont été simples pour 112 patients (96,55%) et compliquées chez 4 patients. Ces complications étaient corrélées aux interventions d’urgence. La durée moyenne d’hospitalisation était de 2,4 jours. Conclusion. Dans notre expérience, la technique de Lichtenstein donne des résultats post opératoires immédiats satisfaisants.
ABSTRACT
Objective. To report our experience in the management of inguinal hernia by prosthesis according to the Lichtenstein procedure. Population and methods. We carried out a descriptive cross-sectional retrospective study from June 2018 to may 2021 in the digestive surgery department of the Brazzaville University Hospital Center. It focused on patients followed for inguinal hernia and operated using the Lichtenstein procedure. We collected epidemiological, diagnostic, therapeutic and follow-up data. The type of the hernia was classified according to NYHUS. Results. Lichtenstein operated hernias represented 43.12 % of all hernias. We studied 116 patients, including 110 men (91.38 %). The mean age of the patients was 45.83 ± 19.67 years, with extremes of 17 and 90 years. 64.66 % of patients has a herniogenic factor. Swelling (100%) and pain (54.31 %) were the main reasons for consultation. There were 65 cases of inguinal hernia (52%) and 65 cases of inguinoscrotal hernia (48 %). 93.96 % of patients were operated on in program and 6.04% in emergency. In 73.60 % of cases, the approach was transverse. NYHUS type IIIB hernia accounted for 47.2 %. The cure was carried out in all cases with rectangular polypropylene of 11 x 6 cm. The immediate postoperative period was simple in 112 patients (96.55 %) and complicated in 4 patients (3.45 %). These complications were correlated with emergency interventions. The mean hospital stay was 2.4 ± 0.85 days. Conclusion. In our practice, the Lichtenstein technique has good immediate postoperative results.
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References
- Nyhus L. a classification of groin hernia. In: Arregui ME, Nagan R eds. inguinal hernia: advances or controversies? New York: Radcliffe Medical Press, 1991 : 99-102.
- Diop. B, Sall I, Sow O, Ba P A, Konate I, Dieng M, Wilson E, Wane Y, Sarré SM. 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.
- De Goede B et al. Risk factors for inguinal hernia in middleaged and elderly men: results from the Rotterdam Study. J surgery. 2015; 157(3): 540-546.
- Bay-Nielsen M, Kehlet H, Strand L. Quality assessment of 26304 herniorraphies in Denmark: a prospective nationwide study. Lancet 2001; 358:1124-8.
- Traoré D, Diarra L, Coulibaly B, Bengaly B, Togola B, Traoré A, Traoré H, Ongoïba N, Sissoko F, Koumaré AK. Inguinal hernia in sub-Saharan Africa: what role for Shouldice technique?. Pan Afr Med J. 2015 Sep 18; 22:50.
- Enyinnah M, Dienye PO, Njoku P. Inguinal mesh hernioplasties: a rural private clinic experience in South Eastern Nigeria. Glob J Health Sci. 2013. 13; 5(4):176-81.
- H. Kulaçoğlu, “Current options in umbilical hernia repair in adult patients.,” Ulus Cerrahi Derg. 2015. 31(3) : 157–161.
- Andresen K, Bisgaard T, Rosenberg J. Sliding inguinal hernia is a risk factor for recurrence. Langenbecks Arch Surg. 2015;400(1):101-106.
- Ashindoitiang JA, Ibrahim NA, Akinlolu OO. Risk factors for inguinal hernia in adult male Nigerians: a case control study. Int J Surg. 2012; 10(7):364-7.
- Argo M, Favela J, Phung T, Huerta S (2019) Local vs other forms of anesthesia for open inguinal hernia repair: a meta-analysis of randomized controlled trials. Am J Surg 218:1008–1015.
- Simons MP, Aufenacker T, Bay-Nielsen M et al (2009) European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 13(4):343–403.
- I Konaté, M Cissé, T Wade, PA Ba, J Tendeng, B Sine, M Dieng, Y Alami, A Dia, CT Touré. Prise en charge des hernies inguinales a la clinique chirurgicale de l’hôpital Aristide Le Dantec de Dakar : Etude rétrospective a propos de 432cas. J Afr Chir Digest 2010; 10 (2):1086 – 9.
- Balentine CJ, Meier J, Berger M et al (2021) Using local anesthesia for inguinal hernia repair reduces complications in older patients. J Surg Res 258:64–72.
- Pélissier E. Anatomie Chirurgicale des Hernies de l’aine. Technique chirurgicale Appareil digestif Encycl Med chir Paris 2000; 3: 40-105.
- S. S. Bessa • K. M. Katri • W. N. Abdel-Salam • N. A. Abdel-Baki. Early results from the use of the Lichtenstein repair in the management of strangulated groin hernia. Hernia. 2007 ; 11:239–242.
- Harjai MM, Nagpal BM, Singh P, Singh Y. A Prospective Randomized Controlled Study of Lichtenstein's Tension Free versus Modified Bassini Repair in the Management of Groin Hernias. Med J Armed Forces India. 2007; 63(1):40-3
- Olasehinde O, Lawal OO, Agbakwuru EA, Adisa AO, Alatise OI, Arowolo OA, Adesunkanmi AR, Etonyeaku AC. Comparing Lichtenstein with darning for inguinal hernia repair in an African population. Hernia. 2016; 20(5):667-74.
- Alfieri S, Amid PK, Campanelli G et al. International guidelines for prevention and management of post-operative chronic pain following inguinal hernia surgery. Hernia 2011;15: 239-49.
References
Nyhus L. a classification of groin hernia. In: Arregui ME, Nagan R eds. inguinal hernia: advances or controversies? New York: Radcliffe Medical Press, 1991 : 99-102.
Diop. B, Sall I, Sow O, Ba P A, Konate I, Dieng M, Wilson E, Wane Y, Sarré SM. 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.
De Goede B et al. Risk factors for inguinal hernia in middleaged and elderly men: results from the Rotterdam Study. J surgery. 2015; 157(3): 540-546.
Bay-Nielsen M, Kehlet H, Strand L. Quality assessment of 26304 herniorraphies in Denmark: a prospective nationwide study. Lancet 2001; 358:1124-8.
Traoré D, Diarra L, Coulibaly B, Bengaly B, Togola B, Traoré A, Traoré H, Ongoïba N, Sissoko F, Koumaré AK. Inguinal hernia in sub-Saharan Africa: what role for Shouldice technique?. Pan Afr Med J. 2015 Sep 18; 22:50.
Enyinnah M, Dienye PO, Njoku P. Inguinal mesh hernioplasties: a rural private clinic experience in South Eastern Nigeria. Glob J Health Sci. 2013. 13; 5(4):176-81.
H. Kulaçoğlu, “Current options in umbilical hernia repair in adult patients.,” Ulus Cerrahi Derg. 2015. 31(3) : 157–161.
Andresen K, Bisgaard T, Rosenberg J. Sliding inguinal hernia is a risk factor for recurrence. Langenbecks Arch Surg. 2015;400(1):101-106.
Ashindoitiang JA, Ibrahim NA, Akinlolu OO. Risk factors for inguinal hernia in adult male Nigerians: a case control study. Int J Surg. 2012; 10(7):364-7.
Argo M, Favela J, Phung T, Huerta S (2019) Local vs other forms of anesthesia for open inguinal hernia repair: a meta-analysis of randomized controlled trials. Am J Surg 218:1008–1015.
Simons MP, Aufenacker T, Bay-Nielsen M et al (2009) European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 13(4):343–403.
I Konaté, M Cissé, T Wade, PA Ba, J Tendeng, B Sine, M Dieng, Y Alami, A Dia, CT Touré. Prise en charge des hernies inguinales a la clinique chirurgicale de l’hôpital Aristide Le Dantec de Dakar : Etude rétrospective a propos de 432cas. J Afr Chir Digest 2010; 10 (2):1086 – 9.
Balentine CJ, Meier J, Berger M et al (2021) Using local anesthesia for inguinal hernia repair reduces complications in older patients. J Surg Res 258:64–72.
Pélissier E. Anatomie Chirurgicale des Hernies de l’aine. Technique chirurgicale Appareil digestif Encycl Med chir Paris 2000; 3: 40-105.
S. S. Bessa • K. M. Katri • W. N. Abdel-Salam • N. A. Abdel-Baki. Early results from the use of the Lichtenstein repair in the management of strangulated groin hernia. Hernia. 2007 ; 11:239–242.
Harjai MM, Nagpal BM, Singh P, Singh Y. A Prospective Randomized Controlled Study of Lichtenstein's Tension Free versus Modified Bassini Repair in the Management of Groin Hernias. Med J Armed Forces India. 2007; 63(1):40-3
Olasehinde O, Lawal OO, Agbakwuru EA, Adisa AO, Alatise OI, Arowolo OA, Adesunkanmi AR, Etonyeaku AC. Comparing Lichtenstein with darning for inguinal hernia repair in an African population. Hernia. 2016; 20(5):667-74.
Alfieri S, Amid PK, Campanelli G et al. International guidelines for prevention and management of post-operative chronic pain following inguinal hernia surgery. Hernia 2011;15: 239-49.