Mesh repair versus anatomical repair of ruptured umbilical hernia in cirrhotic patients, our center experience.

PURPOSE: Ruptured umbilical hernia (UH) is a life-threatening condition in cirrhotic patients with a morbidity and mortality rate of 30%. Despite its high risk, the best surgical treatment strategy for this condition remains controversial. This study aimed to evaluate the feasibility and safety of mesh repair of ruptured UH.

METHODS

149 patients who underwent surgical management for ruptured UH between January 2018 and December 2022 were included in this retrospective study. The patients were divided into two groups: anatomical repair (group 1, n = 92) and mesh repair (group 2, n = 57). Hernia recurrence, wound infection, and other perioperative morbidity and mortality were evaluated.

RESULTS

The recurrence of hernia was significantly lower after mesh repair (5.3% vs. 17.4%, P = 0.03). Other postoperative complications were not significantly different between the two groups. However, the incidence of wound infection after mesh repair was higher than that after anatomical repair, but this was statistically non-significant (12.3% vs. 8.7%, p = 0.48). Two patients in the mesh repair group required mesh removal due to infection.

CONCLUSIONS

Mesh repair of ruptured UH in cirrhotic patients is a feasible and safe surgical option that results in a significantly lower hernia recurrence rate with acceptable morbidity and mortality, provided that careful patient optimization is carried out.