Skip to main content
Erschienen in: World Journal of Surgery 11/2015

01.11.2015 | Original Scientific Report

The Usefulness of International Cooperation in the Repair of Inguinal Hernias in Sub-Saharan Africa

verfasst von: José Gil, J. M. Rodriguez, E. Gil, Q. Hernández Agúera, F. M. González, J. A. García, M. D. Balsalobre, J. A. Tortosa, D. Hernández Palazón, A. B. Diallo, P. Parrilla

Erschienen in: World Journal of Surgery | Ausgabe 11/2015

Einloggen, um Zugang zu erhalten

Abstract

Introduction

The burden of disease and mortality associated with inguinal hernia in Africa, especially in sub-Saharan Africa, is very high. The purpose of this study is to show that International Cooperation work in the field of hernia repair is effective; it minimizes the delay in hernia repairs in the targeted population, and can prevent a large number of disability-adjusted life years (DALYs).

Materials and methods

As a part of an International Cooperation program, a total of 990 black patients with inguinal hernias were studied, in whom hernioplasty was performed using polypropylene mesh. The type of hernia and surgical technique were studied. Indicators of scientific and technical quality, indicators of efficiency and of effectiveness were analyzed. The results on the usefulness of interventions were calculated as avoided DALYs.

Results

Surgery was performed on 926 patients with a total of 1033 hernia repairs. 87.2 % of the repairs were made with mesh. There was no mortality in the series, complications were minor, and 85.7 % of patients remained less than 24 h in the center. There was a 2.8 % of recurrence, with a follow-up 58.7 % of the patients in the first year. 5014 DALYs were avoided, and the average of the avoided DALYs per patient was of 5.41.

Conclusions

Hernia repair with mesh in low development countries is a procedure with low morbidity and high effectiveness that can prevent a large number of DALYs.
Literatur
1.
Zurück zum Zitat Belcher DW, Nyame PK, Murapa FK (1978) The prevalence of inguinal hernia in Ghanaian males. Trop Georgr Med 30:39–43 Belcher DW, Nyame PK, Murapa FK (1978) The prevalence of inguinal hernia in Ghanaian males. Trop Georgr Med 30:39–43
2.
Zurück zum Zitat Yardov YS, Stoyanov SK (1969) The incidence of hernia on the island of Pemba. East Afr Med J 46:687–691 Yardov YS, Stoyanov SK (1969) The incidence of hernia on the island of Pemba. East Afr Med J 46:687–691
3.
Zurück zum Zitat Carbonell JF, Sánchez JL, Peris RT, Ivorra JC, Del Baño MJ, Sánchez CS, Arraez JI, Greus PC (1993) Risk factors associated with inguinal hernias: a case control study. Eur J Surg 159:481–486PubMed Carbonell JF, Sánchez JL, Peris RT, Ivorra JC, Del Baño MJ, Sánchez CS, Arraez JI, Greus PC (1993) Risk factors associated with inguinal hernias: a case control study. Eur J Surg 159:481–486PubMed
4.
Zurück zum Zitat Flich J, Alfonso JL, Delgado M, Prado MJ, Cortina P (1992) Inguinal hernia and certain risk factors. Eur J Epidemiol 8:277–282PubMed Flich J, Alfonso JL, Delgado M, Prado MJ, Cortina P (1992) Inguinal hernia and certain risk factors. Eur J Epidemiol 8:277–282PubMed
5.
Zurück zum Zitat Sanders DL, Porter CS, Mitchell KCD, Kingsnorth A (2008) A prospective cohort study comparing the African and European hernia. Hernia 12:527–529CrossRefPubMed Sanders DL, Porter CS, Mitchell KCD, Kingsnorth A (2008) A prospective cohort study comparing the African and European hernia. Hernia 12:527–529CrossRefPubMed
6.
Zurück zum Zitat Ohene-Yeboah M, Abantanga F, Oppong J, Togbe B, Nimako B, Amoah M et al (2009) Some aspects of the epidemiology of external hernias in Kumasi, Ghana. Hernia 13:529–532CrossRefPubMed Ohene-Yeboah M, Abantanga F, Oppong J, Togbe B, Nimako B, Amoah M et al (2009) Some aspects of the epidemiology of external hernias in Kumasi, Ghana. Hernia 13:529–532CrossRefPubMed
7.
Zurück zum Zitat Ohene-Yeboah M (2003) Strangulated external hernias in Kumasi Ghana. West Afr J Med 22:310–313PubMed Ohene-Yeboah M (2003) Strangulated external hernias in Kumasi Ghana. West Afr J Med 22:310–313PubMed
8.
Zurück zum Zitat Odula PO, Kakande IM (2004) Groin hernia in Mulago Hospital, Kampala. East Central Afr J Surg 9:48–52 Odula PO, Kakande IM (2004) Groin hernia in Mulago Hospital, Kampala. East Central Afr J Surg 9:48–52
9.
Zurück zum Zitat Adesunkanmi ARK, Agbakwuru EA, Badmus TA (2000) Obstructed abdominal wall hernia at the Wesley Guild Hospital, Nigeria. East Afr Med J 77:31–33PubMed Adesunkanmi ARK, Agbakwuru EA, Badmus TA (2000) Obstructed abdominal wall hernia at the Wesley Guild Hospital, Nigeria. East Afr Med J 77:31–33PubMed
11.
Zurück zum Zitat Harouna Y, Yaya H, Abdou I et al (2000) Prognosis of strangulated hernia in adult with necrosis of small bowel: a 34 cases report. Bull Soc Pathol Exot 93:317–320PubMed Harouna Y, Yaya H, Abdou I et al (2000) Prognosis of strangulated hernia in adult with necrosis of small bowel: a 34 cases report. Bull Soc Pathol Exot 93:317–320PubMed
12.
Zurück zum Zitat Rutkow IM (2003) Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Surg Clin North Am 83:1045–1051CrossRefPubMed Rutkow IM (2003) Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Surg Clin North Am 83:1045–1051CrossRefPubMed
13.
Zurück zum Zitat Hair A, Paterson C, Wright D et al (2001) What effect does the duration of an inguinal hernia have on patient symptoms? J Am Coll Surg 193:125–129CrossRefPubMed Hair A, Paterson C, Wright D et al (2001) What effect does the duration of an inguinal hernia have on patient symptoms? J Am Coll Surg 193:125–129CrossRefPubMed
15.
Zurück zum Zitat Beard JH, Oresanya LB, Akoko L, Mwanga A, Dicker RA, Harris HW (2014) An estimation of inguinal hernia epidemiology adjusted for population age structure in Tanzania. Hernia 18:289–295CrossRefPubMed Beard JH, Oresanya LB, Akoko L, Mwanga A, Dicker RA, Harris HW (2014) An estimation of inguinal hernia epidemiology adjusted for population age structure in Tanzania. Hernia 18:289–295CrossRefPubMed
16.
Zurück zum Zitat Ramyil VM, Iya D, Ogbonna BC, Dakum NK (2000) Safety of daycare hernia repair in Jos, Nigeria. East Afr Med J 77:326–328PubMed Ramyil VM, Iya D, Ogbonna BC, Dakum NK (2000) Safety of daycare hernia repair in Jos, Nigeria. East Afr Med J 77:326–328PubMed
17.
Zurück zum Zitat Fall B, Betel ME, Diarra O, Ba M, Dia A, Diop A (2005) Complications of treatment of adult’s groin hernia: a report of 100 cases comparative study between Bassini and MacVay’s techniques. Dakar Med 50:37–40PubMed Fall B, Betel ME, Diarra O, Ba M, Dia A, Diop A (2005) Complications of treatment of adult’s groin hernia: a report of 100 cases comparative study between Bassini and MacVay’s techniques. Dakar Med 50:37–40PubMed
18.
Zurück zum Zitat Adesunkanmi ARK, Badmus TA, Ogundoyin O (2004) Determinants of outcome of inguinal herniorrhaphy in Nigerian patients. Ann Coll Surg H K 8:14–21CrossRef Adesunkanmi ARK, Badmus TA, Ogundoyin O (2004) Determinants of outcome of inguinal herniorrhaphy in Nigerian patients. Ann Coll Surg H K 8:14–21CrossRef
20.
Zurück zum Zitat Kingsnorth AN, Bowley DMG, Porter C (2003) A prospective study of 1000 hernias: results of the Plymouth Hernia Service. Ann R Coll Surg Engl 85:18–22PubMedCentralCrossRefPubMed Kingsnorth AN, Bowley DMG, Porter C (2003) A prospective study of 1000 hernias: results of the Plymouth Hernia Service. Ann R Coll Surg Engl 85:18–22PubMedCentralCrossRefPubMed
21.
Zurück zum Zitat Ohene-Yeboah M, Abantanga FA (2011) Inguinal hernia disease in Africa: a common but neglected surgical condition. West Afr J Med 30(2):77–83PubMed Ohene-Yeboah M, Abantanga FA (2011) Inguinal hernia disease in Africa: a common but neglected surgical condition. West Afr J Med 30(2):77–83PubMed
23.
Zurück zum Zitat Adesunkanmi ARK, Badmus TA, Salako AA (2000) Groin hernias in patients 50 years of age and above pattern and outcome of management in 250 consecutive patients. West Afr J Med 19:142–147PubMed Adesunkanmi ARK, Badmus TA, Salako AA (2000) Groin hernias in patients 50 years of age and above pattern and outcome of management in 250 consecutive patients. West Afr J Med 19:142–147PubMed
24.
Zurück zum Zitat Freudenberg S, Sano D, Ouangré E, Weiss C, Wilhelm TJ (2006) Commercial mesh versus nylon mosquito net for hernia repair. A randomized double-blind study in Burkina Fasso. World J Surg 30:1784–1789. doi:10.1007/s00268-006-0108-3 CrossRefPubMed Freudenberg S, Sano D, Ouangré E, Weiss C, Wilhelm TJ (2006) Commercial mesh versus nylon mosquito net for hernia repair. A randomized double-blind study in Burkina Fasso. World J Surg 30:1784–1789. doi:10.​1007/​s00268-006-0108-3 CrossRefPubMed
25.
Zurück zum Zitat Clarke MG, Oppong C, Simmermacher R, Park K, Kurzer M, Vanotoo L et al (2008) The use of sterilized polyester mosquito net mesh for inguinal hernia repair in Ghana. Hernia 13:155–159CrossRefPubMed Clarke MG, Oppong C, Simmermacher R, Park K, Kurzer M, Vanotoo L et al (2008) The use of sterilized polyester mosquito net mesh for inguinal hernia repair in Ghana. Hernia 13:155–159CrossRefPubMed
26.
27.
Zurück zum Zitat Shillcutt SD, Clarke MG, Kingsnorth AN (2010) Cost-effectiveness of groin hernia surgery in the western region of Ghana. Arch Surg 145:954–961CrossRefPubMed Shillcutt SD, Clarke MG, Kingsnorth AN (2010) Cost-effectiveness of groin hernia surgery in the western region of Ghana. Arch Surg 145:954–961CrossRefPubMed
28.
Zurück zum Zitat Simons MP, Aufenacker T, Bay-Nielsen M et al (2009) European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 13:343–403PubMedCentralCrossRefPubMed Simons MP, Aufenacker T, Bay-Nielsen M et al (2009) European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 13:343–403PubMedCentralCrossRefPubMed
29.
Zurück zum Zitat Kingsnorth AN (2004) A clinical classification for patients with inguinal hernia. Hernia 8:283–284CrossRefPubMed Kingsnorth AN (2004) A clinical classification for patients with inguinal hernia. Hernia 8:283–284CrossRefPubMed
31.
Zurück zum Zitat Murray CJL, Lopez AD (1996) The global burden of disease and risk factors. The World Bank/Oxford University Press, Washington Murray CJL, Lopez AD (1996) The global burden of disease and risk factors. The World Bank/Oxford University Press, Washington
32.
Zurück zum Zitat Musgrove P, Fox-Rushby JA et al (2006) Cost-effectiveness analysis for priority setting. In: Jamison D, Breman J, Measham A (eds) Disease control priorities in developing countries, 2nd edn. World Bank and Oxford University Press, Washington, DC, pp 271–285 Musgrove P, Fox-Rushby JA et al (2006) Cost-effectiveness analysis for priority setting. In: Jamison D, Breman J, Measham A (eds) Disease control priorities in developing countries, 2nd edn. World Bank and Oxford University Press, Washington, DC, pp 271–285
34.
Zurück zum Zitat Shillcutt Samuel D, Sanders David L, M. Teresa Butron-Vila David L, Andrew N. Kingsnorth David L (2013) Cost-effectiveness of ingunial hernia surgery in northwestern Ecuador. World J Surg 37:32–41. doi:10.1007/s00268-012-1808-5 CrossRefPubMed Shillcutt Samuel D, Sanders David L, M. Teresa Butron-Vila David L, Andrew N. Kingsnorth David L (2013) Cost-effectiveness of ingunial hernia surgery in northwestern Ecuador. World J Surg 37:32–41. doi:10.​1007/​s00268-012-1808-5 CrossRefPubMed
35.
Zurück zum Zitat IBDIS (2003) Iran burden of disease and injury study: disability weights. Ministry of Health, Tehran IBDIS (2003) Iran burden of disease and injury study: disability weights. Ministry of Health, Tehran
36.
Zurück zum Zitat Naghavi M, Abolhassani F, Pourmalek F et al (2009) The burden of disease and injury in Iran 2003. Popul Health Metr 15:9CrossRef Naghavi M, Abolhassani F, Pourmalek F et al (2009) The burden of disease and injury in Iran 2003. Popul Health Metr 15:9CrossRef
37.
Zurück zum Zitat Hyder AA, Morrow RH (2000) Applying burden of disease methods in developing countries: a case study from Pakistan. Am J Public Health 90:1235–1240PubMedCentralCrossRefPubMed Hyder AA, Morrow RH (2000) Applying burden of disease methods in developing countries: a case study from Pakistan. Am J Public Health 90:1235–1240PubMedCentralCrossRefPubMed
38.
Zurück zum Zitat McCord D, Chowdhury Q (2003) A cost-effective small hospital in Bangladesh: what it can mean for emergency obstetric care. Int J Gynaecol Obstet 81:83–92CrossRefPubMed McCord D, Chowdhury Q (2003) A cost-effective small hospital in Bangladesh: what it can mean for emergency obstetric care. Int J Gynaecol Obstet 81:83–92CrossRefPubMed
39.
Zurück zum Zitat World Health Organization per capita Health care expenditures, 2004. Geneva, Switzerland: World Health Organization World Health Organization per capita Health care expenditures, 2004. Geneva, Switzerland: World Health Organization
40.
Zurück zum Zitat Gil J, Rodríguez JM, Hernández Q, Gil E, Balsalobre MD, González M, Torregrosa N, Verdú T, Alcaráz M, Parrilla P (2012) Do hernia operations in african international cooperation programmes provide good quality? World J Surg 36(12):2795–2801. doi:10.1007/s00268-012-1768-9 CrossRefPubMed Gil J, Rodríguez JM, Hernández Q, Gil E, Balsalobre MD, González M, Torregrosa N, Verdú T, Alcaráz M, Parrilla P (2012) Do hernia operations in african international cooperation programmes provide good quality? World J Surg 36(12):2795–2801. doi:10.​1007/​s00268-012-1768-9 CrossRefPubMed
41.
Zurück zum Zitat Wilhelm TJ, Anemana S, Kyamanywa P, Rennie J, Post S, Freudenberg S (2006) Anaesthesia for elective hernia repair in rural Ghana—appeal for local anaesthesia in resource—poor countries. Trop Doct 36:147–149CrossRefPubMed Wilhelm TJ, Anemana S, Kyamanywa P, Rennie J, Post S, Freudenberg S (2006) Anaesthesia for elective hernia repair in rural Ghana—appeal for local anaesthesia in resource—poor countries. Trop Doct 36:147–149CrossRefPubMed
42.
Zurück zum Zitat Nordin P, Zetterstrom H, Gunnarsson U, Nilsson E (2003) Local, regional, or general anaesthesia in groin hernia repair: multicentre randomized trial. Lancet 362:853–858CrossRefPubMed Nordin P, Zetterstrom H, Gunnarsson U, Nilsson E (2003) Local, regional, or general anaesthesia in groin hernia repair: multicentre randomized trial. Lancet 362:853–858CrossRefPubMed
43.
45.
Zurück zum Zitat Rathmell JP, Lair TR, Nauman B (2005) The role of intrathecal drugs in the treatment of acute pain. Anesth Analg 101:S30–S43CrossRefPubMed Rathmell JP, Lair TR, Nauman B (2005) The role of intrathecal drugs in the treatment of acute pain. Anesth Analg 101:S30–S43CrossRefPubMed
46.
Zurück zum Zitat Carbonell Tatay F (2002) Inguial hernia: concepts, abbreviations, trends and common sense. Cir Esp 71:171–172CrossRef Carbonell Tatay F (2002) Inguial hernia: concepts, abbreviations, trends and common sense. Cir Esp 71:171–172CrossRef
47.
Zurück zum Zitat Stephenson BM (2003) Complications of open groin hernia repairs. Surg Clin North Am 83:1255–1278CrossRefPubMed Stephenson BM (2003) Complications of open groin hernia repairs. Surg Clin North Am 83:1255–1278CrossRefPubMed
48.
Zurück zum Zitat Holland WW, The EC Working Group on Health Services and Avoidable Death (eds) (1997) European community atlas of avoidable death 1985–1989, 3rd edn. Oxford University Press, Oxford Holland WW, The EC Working Group on Health Services and Avoidable Death (eds) (1997) European community atlas of avoidable death 1985–1989, 3rd edn. Oxford University Press, Oxford
49.
Zurück zum Zitat Bay-Nielsen M, Kehlet H, Strand L, Malmström J, Andersen FH, Wara P, Juul P, Callesen T, Danish Hernia Database Collaboration (2001) Quality assessment of 26,304 herniorrhaphies in Denmark: a prospective nationwide study. Lancet 358(9288):1124–1128CrossRefPubMed Bay-Nielsen M, Kehlet H, Strand L, Malmström J, Andersen FH, Wara P, Juul P, Callesen T, Danish Hernia Database Collaboration (2001) Quality assessment of 26,304 herniorrhaphies in Denmark: a prospective nationwide study. Lancet 358(9288):1124–1128CrossRefPubMed
50.
51.
Zurück zum Zitat Debas HT, Gosselin R, McCord C, A Thind et al (2006) Surgery. In: Jamison D, Breman J, Measham A (eds) Disease control priorities in developing countries, 2nd edn. World Bank and Oxford University Press, Washington, DC, pp 1245–1259 Debas HT, Gosselin R, McCord C, A Thind et al (2006) Surgery. In: Jamison D, Breman J, Measham A (eds) Disease control priorities in developing countries, 2nd edn. World Bank and Oxford University Press, Washington, DC, pp 1245–1259
52.
Zurück zum Zitat Ozgediz D, Jamison D, Cherian M, McQueen K (2008) The burden of surgical conditions and access to surgical care in low- and middle-income countries. Bull World Health Organ 86(8):646–647PubMedCentralCrossRefPubMed Ozgediz D, Jamison D, Cherian M, McQueen K (2008) The burden of surgical conditions and access to surgical care in low- and middle-income countries. Bull World Health Organ 86(8):646–647PubMedCentralCrossRefPubMed
53.
Zurück zum Zitat Murray CJL, Vos T, Lozano R et al (2012) Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions 1990–2010: a systematic analysis for the global burden of disease study 2010. Lancet 380:2197–2223CrossRefPubMed Murray CJL, Vos T, Lozano R et al (2012) Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions 1990–2010: a systematic analysis for the global burden of disease study 2010. Lancet 380:2197–2223CrossRefPubMed
55.
Zurück zum Zitat Weiser TG, Regenbogen SE, Thompson KT, Haynes AB, Lipsitz SR, Berry WR et al (2008) An estimation of the global volume of surgery: a modeling strategy based on available data. Lancet 372:139–144CrossRefPubMed Weiser TG, Regenbogen SE, Thompson KT, Haynes AB, Lipsitz SR, Berry WR et al (2008) An estimation of the global volume of surgery: a modeling strategy based on available data. Lancet 372:139–144CrossRefPubMed
56.
Zurück zum Zitat Bickler SW, Spiegel DA (2008) Global surgery—defining a research agenda. Lancet 372:90–92CrossRefPubMed Bickler SW, Spiegel DA (2008) Global surgery—defining a research agenda. Lancet 372:90–92CrossRefPubMed
Metadaten
Titel
The Usefulness of International Cooperation in the Repair of Inguinal Hernias in Sub-Saharan Africa
verfasst von
José Gil
J. M. Rodriguez
E. Gil
Q. Hernández Agúera
F. M. González
J. A. García
M. D. Balsalobre
J. A. Tortosa
D. Hernández Palazón
A. B. Diallo
P. Parrilla
Publikationsdatum
01.11.2015
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery / Ausgabe 11/2015
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-015-3161-y

Weitere Artikel der Ausgabe 11/2015

World Journal of Surgery 11/2015 Zur Ausgabe

Innovative Surgical Techniques Around the World

Modified Anterior Approach for the ALPPS Procedure: How We Do It

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.