الفهرس 
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Abstract
Paraumbilical hernia is considered one of the most common surgical
problems. It can cause serious complications including strangulation and intestinal
obstruction. Thus, repair of paraumbilical hernia is one of the frequently done
surgical procedures.
There are two main dominating techniques in paraumbilical hernia repair;
suture repair and mesh repair. During the past decade, mesh repair was preferred
to suture repair as it reduced rates of hernia recurrence, but on the other side it has
higher rates of local wound complications.
Therefore, the primary aim of this study was to compare between suture
repair and mesh repair in small-sized paraumbilical hernia regarding hernia
recurrence and local wound complications.
A prospective randomized controlled study was carried out after obtaining
written informed consent from all patients and approval of the ethics committee of
the faculty of medicine, Menoufia University.
A hundred consecutive patients aging above 21 years old attended to
operation rooms at Menoufia university hospital in Shebin Alkom, Egypt. Before
operation, patients were randomized by the use of sealed envelopes technique into
two groups:
group 1: included 50 patients randomized to paraumblical hernioplasty
with mesh insertion.
group 2: included 50 patients randomized to paraumblical herniorrhaphy
(anatomical repair only).
Inclusion Criteria:
All adult patients aging above 21 years old, who underwent paraumblical
hernia repair with a defect less than 3 cm on preoperative ultrasound.
Exclusion Criteria:
Patients with any of the following were excluded from the study:
o Defect more than 3 cm.
o Complicated cases e.g.: intestinal obstruction, strangulation.
o Recurrent paraumbilical hernia.
o Decompensated liver patients.
o Pregnancy.
o Immunosuppressed patients e.g.: under chemotherapy or steroids.
o Past history of midline incisions passing through umbilical region.
All patients were subjected to:
History taking.
Clinical examination.
Summary
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Investigations:
Radiological: U/S to detect the size of the defect and exclude other
intraabdominal pathology.
Routine laboratory investigations: CBC, INR, electrolytes, liver function
test.
Results of the current study could be summarized as follow:
Patients’ demographic data were balanced between groups regarding age, sex
and BMI.
Incision size and time of operation were higher among hernioplasty group
than herniorrhaphy group.
Insertion of drain was increased among hernioplasty group (100%) than
herniorrhaphy group (66%).
Postoperatively, antibiotic use and drain removal timing were significantly
increased among hernioplasty group than herniorrhaphy group. On contrast,
there was no statistically significant difference between both groups
regarding hospital stay.
The overall cost was higher in hernioplasty group than in suture repair group.
There were no statistically significant differences between both groups
regarding recurrence rates after 3rd months and 6th months.
There were no statistically significant differences between both groups
regarding wound complications (p>0.05).
Some variants had positive correlation with each other including:
1. Incision size: had positive correlation with defect size, time of operation,
wound infection and seroma formation.
2. Time of operation: had positive correlation with drain insertion, incision
size and overall cost.
3. Defect size: had positive correlation with drain insertion, incision size and
drain removal timing.
4. Overall cost: showed positive correlation with time of operation, drain
insertion, seroma, infection, wound dehiscence, hospital stay, antibiotic
use and recurrence rates after 6 months.