Early Versus Late Repair of Incisional Hernia Following Laparostomy for Enter cutaneous Fistulas Using Component Separation Technique and Onlay Placement of Polypropylene Mesh

To compare the outcome of early versus late repair of incisional hernia that developed following laparostomy for enterocutaneous fistula.

Authors

  • Ahmad Faraz Surgical Division, Department of Surgery, Lady Reading Hospital, Peshawar
  • Ayaz Gul Surgical Division, Department of Surgery, Lady Reading Hospital, Peshawar
  • Adil Bangash Surgical Division, Department of Surgery, Lady Reading Hospital, Peshawar
  • Shumaila Naseer Surgical Division, Department of Surgery, Lady Reading Hospital, Peshawar
  • Sara Jamil Khan Department of Obstetrics and Gynaecology, Frontier Medical College, Abbottabad
  • Aziz Ur Rehman Department of Surgery, North West School of Medicine, Peshawar

DOI:

https://doi.org/10.33279/jkcd.v13i1.55

Abstract

Objective: To compare the outcome of early versus late repair of incisional hernia that developed following laparostomy for enterocutaneous fistula.

Material and methods: This Randomized controlled trial study was conducted at Surgical C unit, Lady Reading Hospital, Peshawar from 22nd May, 2014 till 21st May, 2017. Following ethical approval, 69 patients were enrolled in the study, amongst which three were lost to follow-up. So, 33 patients in both groups were later on included. In group A, patients were asked to present at an early 3-month delay following confirmation of successful enterocutaneous fistula management after discharge, and Group B patients were asked to come one year later. Both groups were subjected to the same procedure of component separation technique with reinforcement with polypropylene mesh. Data was recorded on a Proforma and post-operative complications were mentioned for a period of 12 months that included seroma/hematoma formation, superficial wound infection, mesh infection, enterocutaneous fistulas, recurrence and mortality.

Results: Following allocation to two groups, the group planned for surgery by the component separation technique (CST) in the early group had a slightly smaller hernia (21.3cm) but this was not significant a difference in comparison (p=0.68). The study was focused at a follow-up for duration for one year during which 19 patients (28.7%) in total had clinical or radiological evidence of recurrence of the incisional Hernia out of which ten patients(30.3%) were from group A. Recurrence in group B occurred in 9 patients(27.2%) (p=0.88) This included three patients (4.5%) from both groups with infected meshes that needed removal.

Conclusion: Component Separation technique is a feasible staged approach to management of a ventral wall defect (incisional hernia) with reinforcement of the wall with polypropylene mesh in early phase of recovery after enterocutaneous fi stulas.

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Published

2023-03-31

How to Cite

Faraz, A., Gul, A., Bangash, A. ., Shumaila Naseer, Sara Jamil Khan, & Aziz Ur Rehman. (2023). Early Versus Late Repair of Incisional Hernia Following Laparostomy for Enter cutaneous Fistulas Using Component Separation Technique and Onlay Placement of Polypropylene Mesh: To compare the outcome of early versus late repair of incisional hernia that developed following laparostomy for enterocutaneous fistula. JOURNAL OF KHYBER COLLEGE OF DENTISTRY, 13(1), 28–34. https://doi.org/10.33279/jkcd.v13i1.55

Issue

Vol. 13 No. 1 (2023): Journal of Khyber College of Dentistry

Section

Original Article

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Copyright (c) 2023 Ahmad Faraz, Ayaz Gul, Adil Bangash, Shumaila Naseer, Sara Jamil Khan, Aziz Ur Rehman

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