Incisional Hernia Following Laparotomy among Women in Enugu, Nigeria: A Ten-year Review

Abstract

An incisional hernia may occur in women following laparotomy. Obesity has become an increasing non-communicable public health problem in middle and low-income countries. Also, the caesarean section has been on the increase even among obese women. The study aimed to evaluate the outcome of care and determine the association between caesarean section and obesity in the development of incisional hernias among women who underwent laparotomy for various indications in Enugu, Nigeria. A retrospective study of women who underwent incisional hernia repair between January 2010 and December 2020 at the 2 tertiary hospitals in Enugu, Nigeria, was carried out. The following parameters were assessed; age, predisposing factors, presence and absence of obesity and the class of obesity, comorbidity, presenting symptoms, duration of symptoms before presentation, the interval between presentation and intervention, intra-operative finding, the definitive operative procedure performed, complications of treatment, and outcome of treatment. A total of 46 patients were evaluated. Their mean age was 44 years. Caesarean section and obesity were the most frequently performed laparotomy (31/46, 67.5%) and most common comorbidity (41/46, 89.2%) respectively among the participants. The majority of the patients (44/46, 95.7%) had mesh repair of the incisional hernia, and most had no post-operative complications. There was no significant relationship between incisional hernia and obesity, p = 0.446. There was no mortality. In conclusion, caesarean section, a frequently performed laparotomy, and obesity as comorbidity were frequently associated with the occurrence of incisional hernia among the participants. The use of appropriate mesh and techniques were associated with good results and reduced recurrence.