Abstract
Background: Ventral hernias of the abdomen are non-inguinal, non-hiatal defects in the fascia of the abdominal wall. Surgical procedure of the ventral hernias have evolved over the period of time2. The most basic approach is a primary open repair without mesh, which should typically be reserved for defects in the fascia of less than 3 cm. In our study we aim to compare outcomes of vertical closure versus horizontal closure of primary defect. A prospective analysis was carried out to compare the results of vertical closure versus horizontal closure of primary defect.
Methods: This prospective observational study was conducted in the Department of Surgery, Great Eastern Medical School and Hospital, Srikakulam, Andhra Pradesh, India. A total of 63 patients diagnosed with anterior abdominal wall hernia between September 2023 to February 2024. Adult patients with hernia defect less than 3 cm in diameter were included. Patients with incarceration or strangulation, after previous hernia repair or other emergency abdominal surgical interventions were excluded. Data collection included thorough history taking and clinical examination along with relevant investigations. The data collected was entered in a Proforma, tabulated, and analysed with the SPSS Statistics software.
Results: A total of 63 patients were [31 patients of group-a and 32 patients of group-b] included in study with 6 months follow up. Females were much more affected than males. Patients in group-b have less post operative pain and had early post operative recovery back to work. Out of types of hernia, epigastric hernia showed more incidences among males. The average age of presentation was 52 years. Obesity was the most common predisposing factor (34%) with female preponderance. Obese patients were also associated with a higher rate of postoperative complications like wound infection and seroma.
Conclusion: The most common ventral hernias in decreasing order of their frequency are incisional hernia, umbilical hernia, para-umbilical hernia, and epigastric hernia. Epigastric and umbilical hernias are more common in males whereas incisional hernia is more common in females. Obesity and constipation were found to be the major predisposing risk factors. Patients in group-b have slightly less post operative pain and had early post operative recovery back to work.