Management of Postoperative Hernias in Resource-limited Countries (Guinea)

Aim: the aim of the study was to contribute to the improvement of the management of ventrations in the general surgery department of CHU Ignace Deen. Material and methods: One-year retrospective descriptive study (January to December 2024), conducted in the general surgery department of CHU Ignace Deen. All complete patient records (medical observation, operative report and follow-up) admitted and operated on in the general surgery department during the study period were included. The variables studied were sociodemographic, clinical, therapeutic and evolutionary. Results: Out of 1,398 procedures performed, we recorded 51 cases of postoperative ventralization, representing 3.65% of the department's total activity. The mean age was 38.13±13.96 years, with extremes of 19 and 72 years. The 29 to 38 age group was the most represented (31.4%). Females predominated, with a sex-ratio of 0.5. Appendectomy (37.3%) and Caesarean section (29.4%) were the procedures most likely to result in ventricular deviations. Fourteen patients were referred (27.5%) and three were admitted as emergencies (5.9%). Abdominal swelling was the main reason for consultation (92.2%), and was located median subumbilically (41.2%). The mean diameter was 11.2±3.8 centimeter, with extremes of 5 and 18 cm. Cure was by mesh in 35 cases (68.63%) and by aponeuroplasty in 16 cases (31.37%). Postoperative recovery was straightforward in 49 patients (96.1%), with two cases of surgical site infection (3.9%). The average length of stay was 11.18±3.76 days. Conclusion: Eventrations are an increasingly frequent complication of conventional surgery (laparotomy). Treatment is essentially surgical. Progress in prosthetic techniques has reduced the risk of recurrence.