Annals of PIMS ISSN:1815-2287 ORIGINAL ARTICLE Inguinal Hernia: Clinical Presentation and Postoperative Complications of Patients when Treated with Desarda Technique Mujahid Ahmed 1 , Farhana Manzoor 2 , Rubab Kausar 3 A u t h o r ` s A B S T R A C T A f f i l i a t i o n Objective: To determine the clinical presentation and postoperative 1 Medical officer department of complications of patients having an inguinal hernia when treated with surgery DHQ Hospital Muzaffar Desarda technique. Garh Study Design and Place: This cross-sectional study has been carried out 2BHU Thatta Qureshi Muzaffar Garh 3 Medical officer Indus Hospital department of surgery of DHQ hospital of Muzaffar Garh from May 2016 Muzaffar Garh to November 2016. A u t h o r ` s Methodology : All cases with diagnosis of inguinal hernia either gender C o n t r i b u t i o n or age more than 18 years were selected in the study. Complete 1 Conceived the topic of research and clinical examination, routine laboratory investigations along with ultrasound collect the data 2 Manuscript writing of abdomen were done. All the patients were underwent Desarda 3,4 Data Analysis technique. Postoperative pain was assessed using visual analogue scale A r t i c l e I n f o (VAS). All the patients were discharged on stabled conditions and all Received: Jan 9 ,2017 the postoperative complications were noted. Data regarding clinical Accepted: Mar 2, 2017 presentation, postoperative pain and post-operative complications were H o w t o C i t e t h i s M a n u s c r i p t recorded in the proforma Ahmed M, Manzoor F, Kausar R. Results: In this study 39 cases incorporated, those were underwent Inguinal Hernia: Clinical surgical management of Desarda technique, mean age of the patients Presentation and Postoperative was 43.4+6.22 years, almost all patients were male 37(94.88%) and Complications of Patients when mostly patients had presentation of right inguinal hernia in 25(64.10%). Treated with Desarda Technique. Swelling and pain were found almost in all cases. Majority of patients Ann. Pak. Inst. Med. Sci. 2017; 32(82.05%) had complaint of mild pain, moderate pain was in 13(1):3-6. 10(25.64%) patients while only 05(12.82%) patients had severe pain. Funding Source: Nil Conflict of Interest: Nil Wound infection was in 15.38%, seroma in 07.69% cases, haematoma Address of Correspondence in 12.82% patients, Abdominal wall stiffness was found in 10.25% cases Dr. Mujahid Ahmed while Intra-abdominal abscesses was in only one patient. drahmedmujahid@gmail.com Conclusion: We concluded that the Desarda technique is the good surgical treatment option for an inguinal hernia; it is the safe and reliable surgical procedure with very low rate postoperative complications and recurrences of hernia. Key Words: Clinical presentation, Inguinal hernia, Desarda technique. Introduction family history for groin hernias. 2 Other different factors Inguinal hernia is a frequent case to come across in the outpatient clinic as well as in emergency. Because of its also responsible include smoking, that causes for the frequency, it remains a common, yet an important defective metabolism of the connective tissues, and the medical problem. 1 Male gender and the old age, are the chronic obstructive pulmonary disease (COPD). 3 Among commonest etiological factors of groin hernia is also the female gender, rural areas residence, big height, and the Ann. Pak. Inst. Med. Sci. 2017 3
Annals of PIMS ISSN:1815-2287 hernia of the umbilicus were the additional etiological surgical this surgical technique. After surgeries complete factors for the inguinal herniation. 4 Lower BMI, collagen postoperative treatment was started. Postoperative pain vascular disease, higher intra-abdominal pressure, was assessed using visual analogue scale (VAS). All the thoracic or abdominal aortic aneurysm, processes patients were discharged on stabled conditions and all the virginals, open appendectomies, and the peritoneal postoperative complications were noted. All the data dialysis were the common causes. 3 Management of the regarding clinical presentation, postoperative pain and inguinal hernia with the local anesthesia is extensively post-operative complications were recorded in the utilized all over the world. 5,6 Local anesthesia with proforma. Data was entered in the SPSS version 16.0, for addition of the sedation utilized for this kind of the the analysis. Mean and slandered deviation will be surgeries is the method with little influence on organs calculated for quantitative data as age, Simple frequency and systems physiology, and also safe and effective, and percentage will be calculated for qualitative data as: easygoing to perform and having less rate of the side gender, clinical presentation, postoperative pain and post- effects, like as CVD, nausea and vomiting or urinary operative complications. retention, allowing mobilization rapidly and subsequent Results short post-operative Hospital stay. 7 Still no medical In this study 39 cases had incorporated, those were recommendation regarding how to manage this disease, underwent surgical management of Desarda technique, due to fact that the until, elective surgeries utilized to be mean age of the patients was 43.4+6.22 years, almost all recommended for the inguinal hernia. Reason behind patients were male 37(94.88%) and mostly patients had these recommendations is feared complication’s risks like presentation of right inguinal hernia in 25(64.10%) and as; incarceration or the strangulations. 3 Though in 12(35.90%) patients had left side while a bilateral hernia patients mostly, surgical repairs are not done for was not found in any case. ( Table I) strangulation prevention, but in the cause of request of Table I: Patients distribution according to the patients, to relieve discomfort. 8 Desarda technique is demographic characteristics (n=39) emerging suture-based procedure. This procedure is the tension-free, mesh-free, and pays attention to surgical Demographic characteristics Frequency (%) physiology of the inguinal canal. 9 The data available to Age 43.4+6.22 years assess the outcome of this technique is less due to centers (Mean+SD) conventionally using old and reliable techniques. 1 Gender Therefore purpose of this study was to determine the Male 37(94.88%) clinical presentation and postoperative complications of Female 02(03.12%) patients having inguinal hernia when treated with Site of Hernia Desarda technique. Right 25(64.10%) Methodology Left 12(35.90%) This cross-sectional study has been carried out Swelling and pain were found almost in all cases, department of surgery of DHQ hospital of Muzaffar following by, tenderness, feeling heaviness, constipation, Garh. Study duration was 7 months from May 2016 to nausea and vomiting, dilated bowel loops with percentage November 2016. All cases with diagnosis of inguinal of 61.59%, 51.28%, 41.02%, 25.64%, 20.51% and hernia either gender or age more than 18 years were 30.76% respectively . Figure:1 selected in the study. All cases with recurrent hernia and Majority of patients 32(82.05%) had complaint of mild having severe comorbidities as; uncontrolled diabetes and pain, moderate pain was in 10(25.64%) patients while chronic hepatitis etc, were excluded from the study. A only 05(12.82%) patients had severe pain. according to written consent was taken from all the cases and their other postoperative complications wound infection was in attendants. Complete clinical examination, routine 15.38%, seroma in 07.69% cases, haematoma in 12.82% laboratory investigations along with ultrasound of patients, Abdominal wall stiffness was found in 10.25% abdomen were done. Patients were underwent Desarda cases while Intra-abdominal abscesses was in only one technique and surgeries were done by experienced and patient. (Table II) skilled surgeon. All the cases were explained regarding Ann. Pak. Inst. Med. Sci. 2017 4
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