Rouet J, Bwelle G, Cauchy F, Masso-Misse P, Gaujoux S, Dousset B
Department of Digestive, Endocrine and HPB Surgery, hôpital Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
Department of General and Digestive Surgery, hôpital Central de Yaoundé, Yaoundé, Cameroon.
J Visc Surg. 2018 Apr;155(2):111-116. doi: 10.1016/j.jviscsurg.2017.10.006. Epub 2017 Nov 2.
In developing countries, most inguinal hernia repairs are performed using Bassini or Shouldice techniques resulting in higher recurrence rates than with mesh placement. Our study aimed to evaluate the postoperative course and quality of life of patients undergoing inguinal hernia repair with a polyester mosquito net meshes during non-governmental organization health campaigns in Cameroon.
Patients were prospectively included from January to November 2013. Meshes were made from a polyester non-impregnated mosquito net purchased at a local market in Yaounde and sterilized on site.
The total cost of a mesh was 0.21 USD. Among the 41 patients included in the study, 33 (80.5%) were men, 30 (72%) were farmers and the median age was 52 (21-80) years. The time between the onset of symptoms and surgery was 24 (3-240) months. Eleven (26.8%) patients had a previous history of hernia repair: 4 (9.7%) had been operated on the contralateral side and 7 (17.1%) had a recurrence. No intraoperative event related to the meshes was recorded. Three patients (7.2%) had a postoperative uninfected scrotal seroma, and 1 patient (2.4%) experienced a superficial skin infection that was treated using local care and oral antibiotics. No allergic rejection or deep infection was observed.
Meshes made from sterilized mosquito nets are safe and effective and provide a cost-effective alternative to commercially available meshes in countries with limited resources especially during non-governmental organization health campaigns.
在发展中国家,大多数腹股沟疝修补手术采用巴西尼(Bassini)或肖尔代斯(Shouldice)技术,导致复发率高于使用补片的情况。我们的研究旨在评估喀麦隆非政府组织健康活动期间,使用聚酯蚊帐补片进行腹股沟疝修补手术的患者术后病程及生活质量。
前瞻性纳入2013年1月至11月的患者。补片由在雅温得当地市场购买的未浸渍聚酯蚊帐制成,并在现场进行消毒。
一片补片的总成本为0.21美元。纳入研究的41例患者中,33例(80.5%)为男性,30例(72%)为农民,中位年龄为52岁(21 - 80岁)。症状出现至手术的时间为24个月(3 - 240个月)。11例(26.8%)患者有疝修补手术史:4例(9.7%)曾在对侧进行手术,7例(17.1%)有复发。未记录到与补片相关的术中事件。3例患者(7.2%)术后出现未感染的阴囊血清肿,1例患者(2.4%)发生浅表皮肤感染,经局部护理和口服抗生素治疗。未观察到过敏反应或深部感染。
在资源有限的国家,尤其是在非政府组织健康活动期间,由消毒蚊帐制成的补片安全有效,是市售补片具有成本效益的替代方案。