Suture repair of umbilical hernia during caesarean section: a case-control study.

Details

Serval ID
serval:BIB_3B2E81110043
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Suture repair of umbilical hernia during caesarean section: a case-control study.
Journal
Hernia
Author(s)
Steinemann D.C., Limani P., Ochsenbein N., Krähenmann F., Clavien P.A., Zimmermann R., Hahnloser D.
ISSN
1248-9204 (Electronic)
ISSN-L
1248-9204
Publication state
Published
Issued date
2013
Peer-reviewed
Oui
Volume
17
Number
4
Pages
521-526
Language
english
Notes
Publication types: Journal Article; PDF : ORIGINAL ARTICLE
Abstract
PURPOSE: The objective of this study was to investigate the additional burdens in terms of pain, prolongation of surgery and morbidity which is added to elective caesarean section if umbilical hernia suture repair is performed simultaneously. Secondly, patient's satisfaction and hernia recurrence rate were assessed.
METHODS: Consecutive women with symptomatic umbilical hernia undergoing internal or external suture repair during elective caesarean were included in this retrospective cohort-control study. Data on post-operative pain, duration of surgery and morbidity of a combined procedure were collected. These patients were matched 1:10 to women undergoing caesarean section only. Additionally, two subgroups were assessed separately: external and internal suture hernia repair. These subgroups were compared for patient's satisfaction, cosmesis, body image and recurrence rate.
RESULTS: Fourteen patients with a mean age of 37 years were analysed. Internal suture repair (n = 7) prolonged caesarean section by 20 min (p = 0.001) and external suture repair (n = 7) by 34 min (p < 0.0001). Suture repair did not increase morphine use (0.38 ± 0.2 vs. 0.4 ± 02 mg/kg body weight), had no procedure-related morbidity and prolonged hospitalization by 0.5 days (p = 0.01). At a median follow-up of 37 (5-125) months, two recurrences in each surgical technique, internal and external suture repair, occurred (28 %). Body image and cosmesis score showed a higher level of functioning in internal suture repair (p = 0.02; p = 0.04).
DISCUSSION: Despite a high recurrence rate, internal suture repair of a symptomatic umbilical hernia during elective caesarean section should be offered to women if requested. No additional morbidity or scar is added to caesarean section. Internal repair is faster, and cosmetic results are better, additional skin or fascia dissection is avoided, and it seems to be as effective as an external approach. Yet, women must be informed on the high recurrence rate.
Pubmed
Web of science
Create date
30/08/2013 16:19
Last modification date
20/08/2019 13:31
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