Place de la prothèse dans le traitement des petites éventrations postopératoires

Abstract

Next to hernias, incisional hernias repair represent the parietal surgery: the fourth surgical activity in cold pathology in the department of surgery - B at the university hospital of Tlemcen. Their frequency is proportional to the number of recurrence, then, it was obvious to adopt a more effective therapeutic method. The mesh being the only indication for the medium and large incisional hernias, the fact is not true for small incisional hernias where suture repair is still present. Thus a prospective study is done to compare mesh repair to suture repair in small incisional hernias. From January 2007 to June 2011, 70 patients have been operated for small incisional hernias in the context of a prospective and comparative study. The sample population was divided into two groups: 40 patients have had open and laparoscopic mesh repair, and 30 patients have had a suture repair. The date of the first point has been set to the 1st of July 2012. The patient profile is dominated by the female (74.3%) and the obesity (62.9%). The primary criterium of judgement is recurrence since it was found in 13.3% of suture repair versus 2.5% mesh repair with an average drop of 39 months. As far as the secondary criterium are concerned, pain, period of hospital stay and parietal complications (including one mesh rejection) are more important in the mesh repair. In short, the mesh repair is more efficient than suture repair for the treatment of small incisional hernias, its indication must be the first intention, the suture repair is kept for mesh rejection. Key words: mesh, suture repair, prospective and comparative study, small incisional hernias.