Conventional anatomic suture repair versus lightweight mesh repair in the management of complicated umbilical hernia in cirrhotic patients: a randomized control trial

Background Umbilical hernia occurs in 20% of patients with liver cirrhosis. The occurrence of a complication on top of the hernia is a challenging situation. The aim of this study was to compare the conventional anatomical suture repair versus partially absorbable lightweight mesh repair in cirrhotic patients with umbilical hernia undergoing emergency surgery. Patients and methods This prospective randomized study was carried out on 70 cirrhotic patients presented with complicated umbilical hernia in the period from September 2015 to September 2020. The patients were divided randomly into two groups, 35 patients each. Mesh group underwent hernioplasty using the lightweight mesh (polyglecaprone/polypropulene), while suture group underwent herniorrhaphy. Results There were 14 women and 56 men, the mean age was 56.2 +/- 6.2 years. Twelve patients were Child A and 58 patients were Child B. Hernia incarceration was the commonest presentation in 45 patients. There was no statistically significant difference between both groups as regards the mean operative time. The mean hospital stay was 5 +/- 2.5 days in mesh-group patients versus 6.7 +/- 2.1 days in suture group (P=0.043). Wound seroma occurred in 17.2% of sutured group and 8.6% in the mesh group. Conclusion Partially absorbable lightweight mesh repair in cirrhotic patients with complicated umbilical hernia can be performed with minimal wound-related morbidity and a significantly lower rate of recurrence, in comparison with suture group.