Comparison of Mayo's Repair and Mesh Repair in Para Umbilical Hernias

Objective: To compare the outcome of Mayo's repair and mesh repair of para umbilical hernia in Lady reading Hospital Peshawar.

Setting: Department of Surgery, Lady Reading Hospital, Peshawar.

Study Design: Randomized Controlled Trial.

Duration of Study: From 26/03/2020 to 27/09/2020.

Materials and Methods: A total of 60 patients with para umbilical hernia were randomly allocated in two groups, patients in group A were subjected to Mayo’s repair and in group B to Mesh repair. All patients were followed up to determine the pain on 3rd postoperative day and hospital stay in days.

Results: The mean age of the whole study sample was 43.2 (9.9 SD) years. Mean age of group A was 44.3 (9.6) years and in group B it was 42.1 (10.3) years (p 0.390). There were 53.3% males in group A compared to 66.7% in group B (p 0.292). The mean BMI of the study sample was 27.6 (3.3) kg/m2. The man BMI in group A was 27.9 (3.5) kg/m2 compared to 27.4 (3.2) kg/m2 ¬in group B (p 0.561). On 3rd post operative day, the difference in pain on VAS between two groups was comparable; no pain (30% vs 33%), mild pain (46.7% vs 50%) and moderate pain (23.3% vs 16.7%) between Mayo repair and mesh repair respectively (p 0.810). With regards to hospital stay, the difference between two groups was comparable; 1-3 days (33.3% vs 30%), 4-6 days (43.3% vs 53.3%) and > 6 days (23.3% vs 16.7%) between Mayo repair and mesh repair respectively (p 0.706).

Conclusion: Mayo’s repair is not superior to Mesh repair in terms of pain and hospital stay. However, our sample size of low and many effect modifiers were not addressed in this study which can affect the outcome. We recommend more research comparing these two methods on a larger sample size and taking into account the predictors of poor or worse pain outcome before recommending Mayo’s repair as a routine for paraumbilical hernia repair.