Hernioplastias umbilicales en adultos. Análisis a largo plazo

Abstract

Despite its high prevalence, umbilical hernia has not been analyzed likeother abdominal wall defects. No consensus has yet been reached on the ideal surgical option and several alternatives are being used for treatment. Nowadays,the systematic use of prostheses for hernia repair is the recommended approach. ObjectiveTo evaluate long-term results of umbilical hernia treatment with prosthetic mesh. DesignProspective observational study. Location of the studyPrivate University Clinic. Materials and methods180 umbilical hernias were analyzed between January 1st 2005 and June 1st 2012. Hernias with rings between 1 and 3cm diameter were repaired placing a “plug” or a polypropylene “cone”; defects larger than 3cm were repaired with preperitoneal mesh. ResultsThe average age was 48 years old, 70 patients were female and 149 of the cases were primary hernias. From a total of 180 patients, 139 had a hernia ring of between 1 and 3cm. A polypropylene cone was placed in 83 cases and a plug in 56. The rest (n=41) had rings larger than 3cm, and were treated with preperitoneal mesh. ComplicationsThirteen patients reported complications; 3 developed hematomas (1.6%), 8 seromas (4.4%) and operative site infection was observed in 2 patients (1.1%). After 42 months of follow-up, the recurrence rate was 1.1% (2 cases). The follow-up was achieved in 70% cases after an average period of three and a half years. ConclusionsThe use of a polypropylene mesh in umbilical hernia repair has proven to be a safe and easily reproducible technique with a low percentage of complications and recurrences.