Research Article
Nneka A Sunday-Nweke*, Emmanue
Abstract
Introduction: Inguinal hernia repair is one of the most frequently performed surgical procedures in general surgery. Over millions of hernia repairs are performed per year globally. In Africa due to poor documentation, the number of inguinal hernia repair per year is unknown. Estimated values showed 175 per 100000, per year. In spite of this number, in Africa the most appropriate repair technique (including incision choice) is yet to be decided. In open inguinal hernia repair, two known incisions are commonly used: Transverse and Oblique groin incisions. Statistical evidence has not shown any added advantages in choosing any of the incisions except for a better scar appearance in using transverse skin crease incision. Objective: To determine whether a transverse or oblique incision conferred any advantages to the patients, who underwent inguinal herniorraphy in terms of operating time, and quality of life. Method: All patients aged 16 years or older with uncomplicated inguinal hernia presenting at surgical outpatient clinic, who were physically stable and gave informed consent were recruited. These patients were grouped into TEST and CONTROL. An open and close-ended proforma was used both from the clinic, morning of surgery and during follow-up visits to assess the outcome measures. Results: Of the 107 patients recruited, 90 (84.1%) were males while 17 (15.9%) were females. Their ages ranged from 16 years to 85 years with median age of 48 years (53.3%) of these 55 (51.4%) had direct hernia, 39 (36.4%) had indirect and 13 (12.2%) had both. Same surgeon operated on all the patients. Fifty four (54) patients were recruited for the transverse group while fifty three (53) patients had their hernias repaired with oblique incision. Mean operating time for transverse group was 46.89 minutes while that for oblique group was 61.17 minutes (p=0.000). Postoperative pain assessment was not significantly different between the two groups (p=0.148). Patients in the transverse group had better quality of life than the oblique group (p=0.011). Conclusion: Transverse skin incision affords shorter operating time, and better quality of life compared to oblique skin incision in inguinal hernioraphy surgeries.