INCIDENCE OF DELEYED RECURRENCE IN INGUINAL HERNIA REPAIR WITH POLYPROPYLENE DARN.

Abstract

BACKGROUND: Inguinal Hernia is a global issue, adults with developed posterior wall of inguinal
canal needs an effective, safe, and cost effective tension free repair.
OBJECTIVE: To know about the effectiveness of poly propylene darn in inguinal hernia, in terms of
delayed recurrence.
METHODS: It is a descriptive study which was conducted in Saidu Group of Teaching Hospitals;
Saidu Sharif Swat From January 1999 to May 2013. Total of 386 patients collected by non probability
convenient sampling technique, and 390 repairs (4-patient with bilateral inguinal hernia repair) were
included in the study. 180 were indirect, out of these 15 were strangulated, while 210 were of direct
verity. 90 repairs were made under local anesthetic block, 300 were operated under general anesthesia.
Our last case of the series was operated in May 2004. All the patients were discharged on either 1st or 2nd
postoperative day. 3 patients (0.76%) were readmitted for wound infection and were discharged on 8th
postoperative day. Patients were subsequently examined on day 7th and 14lh post operative day for early
complications and then on 6th month and yearly for 9 years, for delayed recurrence. Data were collected
on structured proforma and were analyzed on SPSS.
RESULTS: Ages ranged in our study were from 20-80 years (mean of 50 years). 180 patients had
indirect hernia (46.15%), while 210 were of direct verity. Among 390 repairs 15 patients (3.8%)
developed superficial wound infection, 5 patients (0.8%) established deep wound infection. 3 patients
(0.76%) developed scrotal hematoma, only one case (0.25%) was re explored. 20 patients (5.18%) went
into urinary retention and were catheterized for 24 hours. 2 patients (0.5%) developed early recurrence
with in the first year. 1 patient (0.25%) presented with hydrocele. 2 patients (0.51%) complained of
neuralgia at groin.
During the long follow up for delayed recurrence we lost 58 patients (died, went abroad and some were
not willing for this follow up)among the remaining 328 patients 7 patients developed delayed recurrence
2 were bilateral(2.4%). They were re operated and this time meshplasty with poly propylene mesh
carried out.
CONCLUSION: We concluded that Dam repair with polypropylene is safe and cost-effective, even in
terms of delayed recurrence of inguinal hernia, and recommend it for primary hernia repair.
Key Words: Inguinal hernia, Polypropylene Dam, Delayed Recurrence.