Aim: the aim of the study was to contribute to the improvement of the management of ventrations in the general surgery department of CHU Ignace Deen. Material and methods: One-year retrospective descriptive study (January to December 2024), conducted in the general surgery department of CHU Ignace Deen. All complete patient records (medical observation, operative report and follow-up) admitted and operated on in the general surgery department during the study period were included. The variables studied were sociodemographic, clinical, therapeutic and evolutionary. Results: Out of 1,398 procedures performed, we recorded 51 cases of postoperative ventralization, representing 3.65% of the department's total activity. The mean age was 38.13±13.96 years, with extremes of 19 and 72 years. The 29 to 38 age group was the most represented (31.4%). Females predominated, with a sex-ratio of 0.5. Appendectomy (37.3%) and Caesarean section (29.4%) were the procedures most likely to result in ventricular deviations. Fourteen patients were referred (27.5%) and three were admitted as emergencies (5.9%). Abdominal swelling was the main reason for consultation (92.2%), and was located median subumbilically (41.2%). The mean diameter was 11.2±3.8 centimeter, with extremes of 5 and 18 cm. Cure was by mesh in 35 cases (68.63%) and by aponeuroplasty in 16 cases (31.37%). Postoperative recovery was straightforward in 49 patients (96.1%), with two cases of surgical site infection (3.9%). The average length of stay was 11.18±3.76 days. Conclusion: Eventrations are an increasingly frequent complication of conventional surgery (laparotomy). Treatment is essentially surgical. Progress in prosthetic techniques has reduced the risk of recurrence.
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Itatsu K, Yokoyama Et, Sugawara G, Kubota H, Tojima Y, Kurumiya Et, Kono H, Yamamoto H, Ando M, Nagino M. Incidence of and risk factors for incisional hernia after abdominal surgery. Br J Surg. 2014; 101(11): 1439-47.
R. Payne, J Aldwinckle, Quartier S Meta-analysis of randomized trials comparing the use of prophylactic mesh to standard median closure in the reduction of incisional hernias. Hernia. 2017; 21(6): 843-853.
. This incidence may exceed 20% in patients at higher risk (obese, diabetic, midline laparotomy and surgical site infection)
[3]
R. Payne, J Aldwinckle, Quartier S Meta-analysis of randomized trials comparing the use of prophylactic mesh to standard median closure in the reduction of incisional hernias. Hernia. 2017; 21(6): 843-853.
It is characterized by the protrusion of viscera through a defect in the abdominal wall, at the level of an operative scar, without skin rupture
[4]
Roland W. Luijendijk, Wim C. J. Hop, M. Petrousjka van den Tol, Diederik C. D. de Lange, Marijel M. J. Braaksma, Jan N. M. IJzermans, Roelof U. Boelhouwer, Bas C. de Vries, Marc K. M. Salu, Jack C. J. Wereldsma, Cornelis M. A. Bruijninckx, and Johannes Jeekel. A Comparison of Suture Repair with Mesh Repair for Incisional Hernia. New England journal of medecine 2000; 343: 392-398.
Several risk factors have been identified, including surgical site infections, obesity, postoperative coughing efforts, as well as technical factors related to parietal closure
. In addition to the aesthetic and functional impact, ventration can give rise to serious complications such as strangulation, often necessitating revision surgery.
Management is based on surgical repair, ideally with a prosthesis, which reduces recurrence rates compared with simple stenting.
Despite its high incidence, the functional and economic consequences it entails, and recent advances in prevention and treatment, it remains a major issue in modern abdominal surgery.
The aim of the study was to contribute to improving the management of ventrations in the general surgery department of CHU Ignace Deen.
2. Material and Methods
one-year retrospective descriptive study (January to December 2024), conducted in the general surgery department of CHU Ignace Deen.
All complete patient records (medical observation, operative report and follow-up) operated on in the department during the study period were included. All incomplete files have been excluded. The sampling was simple random. The sample size was calculated using OpenEpi. The data collection was done on cobokollecet and the analysis on SPSS. The parameters studied were sociodemographic, clinical, therapeutic and evolutionary.
3. Results
Out of 1,398 procedures performed, we recorded 51 cases of postoperative ventralization, representing 3.65% of the department's total activity. The mean age was 38.13±13.96 years, with extremes of 19 and 72 years. The 29 to 38 age group was the most represented (31.4%), the other age groups are listed in Table 1.
Women predominated (64.7%), with a sex ratio of 0.5. They were housewives (43.2%), civil servants (33.3%), soldiers (9.8%), farmers (9.8%) and workers (3.9%). They lived in urban areas in 39 cases (76%). They were uneducated (54.9%), with primary (9.8%), secondary (21.6%) and university (13.7%) education. Fourteen patients were referred (27.5%) and three were admitted as emergencies (5.9%). Appendectomy (37.3%) and caesarean section (29.4%) were the procedures most likely to cause ventration, hernia repair (21.6%) and hysterectomy (5.9%). Hypertension was noted in 3 patients, diabetes in 2 and obesity in 3. Abdominal swelling was the main reason for consultation (92.2%), the other signs are shown in Figure 1. It was median subumbilical (41.2%), above and below umbilical (19.6%), above umbilical (9.8%) and at Mac Burney's point (29.4%). The mean diameter was 11.2±3.8 cm, with extremes of 5 and 18 cm. In 21 patients, it ranged from 10 to 15 cm, in 19 from less than 10 cm and in 11 from more than 15 cm. A pre-therapeutic workup was performed in all patients.
Cure was achieved by mesh placement in 35 cases (68.63%) and by simple raphe in 16 cases (31.37%).
Postoperative recovery was straightforward in 49 patients (96.1%). We noted two cases of surgical site infection (3.9%), one of which occurred when the cure was performed with mesh, which delayed healing, and the second with simple stinging. We noted two cases of recurrence, one of which occurred during mesh insertion. The average length of stay was 11.18±3.76 days. Forty-five patients were hospitalized for less than a week, and six patients were hospitalized for more than a week.
Figure 1. Distribution according to the reasons for consultation.
4. Discussion
The frequency of ventrations in our series is in line with data from a multicenter study in low-income countries, where the rate is around 3.91% after abdominal surgery, rising to 9.9% in the event of infection
[7]
Litian Zhang. Incidence of abdominal incisional hernia in developing country: a retrospective cohort study. Int J Clin Exp Med. 2015; 15; 8(8):13649-13652.
[7]
. Worldwide, the rate is between 2% and 20% after laparotomy.
[8]
Pilar Hernández-Granadosa, Manuel López-Cano, Salvador Morales-Conded, e, Filip Muysomsf, Josep García-Alaminog, José Antonio Pereira-Rodríguez. Incisional Hernia Prevention and Use of Mesh. A Narrative Review. cirugia espagnola. 2018; 96 (2): 76-87.
Abdourahmane Ndong, Jacques Noel Tendeng, Guillaume Tcheutchoua Soh, Adja Coumba Diallo, Mohamed Lamine Diao, Ndiamé Sarr, Ibrahima Bodian, Ibrahima Diarra, Philippe Manyacka Ma Nyemb, Ibrahima Konaté. Management of midline ventral hernias in a surgical department of sub-Saharan Africa: A retrospective cohort study. Ann Med Surg (Lond). 2022:78: 103801.
In Africa, the average age of onset is around 40.5 years
[9]
Abdourahmane Ndong, Jacques Noel Tendeng, Guillaume Tcheutchoua Soh, Adja Coumba Diallo, Mohamed Lamine Diao, Ndiamé Sarr, Ibrahima Bodian, Ibrahima Diarra, Philippe Manyacka Ma Nyemb, Ibrahima Konaté. Management of midline ventral hernias in a surgical department of sub-Saharan Africa: A retrospective cohort study. Ann Med Surg (Lond). 2022:78: 103801.
Adamou Harissou, Amadou Magagi Ibrahim, Habou Oumarou, Magagi Amadou1, Sani Rachi. Epidemiology and treatment of groin and ventral hernias in the Zinder region, Niger Republic. International Journal of Abdominal Wall and Hernia Surgery 6(1): p 23-29, Jan-Mar 2023. |
. This reflects the high proportion of obstetric/gynecological surgeries in our cohort, with aggravating factors such as surgical site infection and poor parietal matching.
In our case, as elsewhere, swelling is the main triggering sign, often motivating consultation, all the more so when discomfort has become disabling in daily or professional activities
[3]
R. Payne, J Aldwinckle, Quartier S Meta-analysis of randomized trials comparing the use of prophylactic mesh to standard median closure in the reduction of incisional hernias. Hernia. 2017; 21(6): 843-853.
. This swelling is the first sign to date, which for an aesthetic issue or functional genes sends the patient for a consultation, before the appearance of complications.
The diagnosis is primarily clinical, based on the observation of a reducible swelling, impulsive and expansive with coughing, topped by an operative scar. It is essential to alert patients to signs of acute complication (sudden pain, irreducibility, digestive disorders), so as to ensure early surgical management.
Numerous studies carried out in West Africa (Senegal, Burkina Faso, Niger) concur that prosthetic parietoplasty is now the reference method, with good medium-term results and a very low recurrence rate, although postoperative pain and infectious complications remain a concern
[14]
Diao ML, Tendeng JN, Manyacka Ma Nyemb P, Ehode C, Wade TMM, Ndaw AL, Cisse M, Konate I, Toure CT. Prosthetic cure of abdominal ventrations: about 15 cases. African Review of Surgery and Specialties 2012; 6(3):5-7.
[15]
Ouedraogo S, Ouangre E, Kambire J. L., Sanou A. Results of ventration cure by retromuscular prosthesis interposition in Burkina Faso. African Review of Surgery and Specialties 2016; 10(1): 19-23.
[14, 15]
.
Conclusion: Eventrations are an increasingly frequent complication of conventional surgery (laparotomy). The increase in the workload of surgeons, gynecologists-obstetricians, the quality of medical devices, and the uneven practice of surgery by unqualified personnel would be largely responsible for the occurrence of hernias in our region. Diagnosis is often easy based on clinical presentation. Treatment is essentially surgical. Progress in prosthetic techniques has reduced the risk of recurrence.
Abbreviations
CHU
University Hospital Center
Conflicts of Interest
The authors declare no conflicts of interest.
References
[1]
Walming S, Angenete E, Block M, Bock D, Gessler B, Haglind. Retrospective review of risk factors for surgical wound dehiscence an incisional hernia. BMC Surg 2017; 17: 19
Itatsu K, Yokoyama Et, Sugawara G, Kubota H, Tojima Y, Kurumiya Et, Kono H, Yamamoto H, Ando M, Nagino M. Incidence of and risk factors for incisional hernia after abdominal surgery. Br J Surg. 2014; 101(11): 1439-47.
R. Payne, J Aldwinckle, Quartier S Meta-analysis of randomized trials comparing the use of prophylactic mesh to standard median closure in the reduction of incisional hernias. Hernia. 2017; 21(6): 843-853.
Roland W. Luijendijk, Wim C. J. Hop, M. Petrousjka van den Tol, Diederik C. D. de Lange, Marijel M. J. Braaksma, Jan N. M. IJzermans, Roelof U. Boelhouwer, Bas C. de Vries, Marc K. M. Salu, Jack C. J. Wereldsma, Cornelis M. A. Bruijninckx, and Johannes Jeekel. A Comparison of Suture Repair with Mesh Repair for Incisional Hernia. New England journal of medecine 2000; 343: 392-398.
Litian Zhang. Incidence of abdominal incisional hernia in developing country: a retrospective cohort study. Int J Clin Exp Med. 2015; 15; 8(8):13649-13652.
[8]
Pilar Hernández-Granadosa, Manuel López-Cano, Salvador Morales-Conded, e, Filip Muysomsf, Josep García-Alaminog, José Antonio Pereira-Rodríguez. Incisional Hernia Prevention and Use of Mesh. A Narrative Review. cirugia espagnola. 2018; 96 (2): 76-87.
Abdourahmane Ndong, Jacques Noel Tendeng, Guillaume Tcheutchoua Soh, Adja Coumba Diallo, Mohamed Lamine Diao, Ndiamé Sarr, Ibrahima Bodian, Ibrahima Diarra, Philippe Manyacka Ma Nyemb, Ibrahima Konaté. Management of midline ventral hernias in a surgical department of sub-Saharan Africa: A retrospective cohort study. Ann Med Surg (Lond). 2022:78: 103801.
Adamou Harissou, Amadou Magagi Ibrahim, Habou Oumarou, Magagi Amadou1, Sani Rachi. Epidemiology and treatment of groin and ventral hernias in the Zinder region, Niger Republic. International Journal of Abdominal Wall and Hernia Surgery 6(1): p 23-29, Jan-Mar 2023. |
Diao ML, Tendeng JN, Manyacka Ma Nyemb P, Ehode C, Wade TMM, Ndaw AL, Cisse M, Konate I, Toure CT. Prosthetic cure of abdominal ventrations: about 15 cases. African Review of Surgery and Specialties 2012; 6(3):5-7.
[15]
Ouedraogo S, Ouangre E, Kambire J. L., Sanou A. Results of ventration cure by retromuscular prosthesis interposition in Burkina Faso. African Review of Surgery and Specialties 2016; 10(1): 19-23.
Yawo, K. S., Kokolype, T., Adama, K., Alpha, D., Mohamed, K., et al. (2025). Management of Postoperative Hernias in Resource-limited Countries (Guinea). Journal of Surgery, 13(4), 112-115. https://doi.org/10.11648/j.js.20251304.17
Yawo, K. S.; Kokolype, T.; Adama, K.; Alpha, D.; Mohamed, K., et al. Management of Postoperative Hernias in Resource-limited Countries (Guinea). J. Surg.2025, 13(4), 112-115. doi: 10.11648/j.js.20251304.17
Yawo KS, Kokolype T, Adama K, Alpha D, Mohamed K, et al. Management of Postoperative Hernias in Resource-limited Countries (Guinea). J Surg. 2025;13(4):112-115. doi: 10.11648/j.js.20251304.17
@article{10.11648/j.js.20251304.17,
author = {Kondano Saa Yawo and Thea Kokolype and Konate Adama and Douno Alpha and Kaba Mohamed and Balde Fatoumata Lamarana and Diallo Mamadou Malipha and Fofana Naby and Diakite Sandaly and Fofana Houssein and Soumaoro Labile Togba and Toure Aboubacar},
title = {Management of Postoperative Hernias in Resource-limited Countries (Guinea)
},
journal = {Journal of Surgery},
volume = {13},
number = {4},
pages = {112-115},
doi = {10.11648/j.js.20251304.17},
url = {https://doi.org/10.11648/j.js.20251304.17},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20251304.17},
abstract = {Aim: the aim of the study was to contribute to the improvement of the management of ventrations in the general surgery department of CHU Ignace Deen. Material and methods: One-year retrospective descriptive study (January to December 2024), conducted in the general surgery department of CHU Ignace Deen. All complete patient records (medical observation, operative report and follow-up) admitted and operated on in the general surgery department during the study period were included. The variables studied were sociodemographic, clinical, therapeutic and evolutionary. Results: Out of 1,398 procedures performed, we recorded 51 cases of postoperative ventralization, representing 3.65% of the department's total activity. The mean age was 38.13±13.96 years, with extremes of 19 and 72 years. The 29 to 38 age group was the most represented (31.4%). Females predominated, with a sex-ratio of 0.5. Appendectomy (37.3%) and Caesarean section (29.4%) were the procedures most likely to result in ventricular deviations. Fourteen patients were referred (27.5%) and three were admitted as emergencies (5.9%). Abdominal swelling was the main reason for consultation (92.2%), and was located median subumbilically (41.2%). The mean diameter was 11.2±3.8 centimeter, with extremes of 5 and 18 cm. Cure was by mesh in 35 cases (68.63%) and by aponeuroplasty in 16 cases (31.37%). Postoperative recovery was straightforward in 49 patients (96.1%), with two cases of surgical site infection (3.9%). The average length of stay was 11.18±3.76 days. Conclusion: Eventrations are an increasingly frequent complication of conventional surgery (laparotomy). Treatment is essentially surgical. Progress in prosthetic techniques has reduced the risk of recurrence.},
year = {2025}
}
TY - JOUR
T1 - Management of Postoperative Hernias in Resource-limited Countries (Guinea)
AU - Kondano Saa Yawo
AU - Thea Kokolype
AU - Konate Adama
AU - Douno Alpha
AU - Kaba Mohamed
AU - Balde Fatoumata Lamarana
AU - Diallo Mamadou Malipha
AU - Fofana Naby
AU - Diakite Sandaly
AU - Fofana Houssein
AU - Soumaoro Labile Togba
AU - Toure Aboubacar
Y1 - 2025/08/19
PY - 2025
N1 - https://doi.org/10.11648/j.js.20251304.17
DO - 10.11648/j.js.20251304.17
T2 - Journal of Surgery
JF - Journal of Surgery
JO - Journal of Surgery
SP - 112
EP - 115
PB - Science Publishing Group
SN - 2330-0930
UR - https://doi.org/10.11648/j.js.20251304.17
AB - Aim: the aim of the study was to contribute to the improvement of the management of ventrations in the general surgery department of CHU Ignace Deen. Material and methods: One-year retrospective descriptive study (January to December 2024), conducted in the general surgery department of CHU Ignace Deen. All complete patient records (medical observation, operative report and follow-up) admitted and operated on in the general surgery department during the study period were included. The variables studied were sociodemographic, clinical, therapeutic and evolutionary. Results: Out of 1,398 procedures performed, we recorded 51 cases of postoperative ventralization, representing 3.65% of the department's total activity. The mean age was 38.13±13.96 years, with extremes of 19 and 72 years. The 29 to 38 age group was the most represented (31.4%). Females predominated, with a sex-ratio of 0.5. Appendectomy (37.3%) and Caesarean section (29.4%) were the procedures most likely to result in ventricular deviations. Fourteen patients were referred (27.5%) and three were admitted as emergencies (5.9%). Abdominal swelling was the main reason for consultation (92.2%), and was located median subumbilically (41.2%). The mean diameter was 11.2±3.8 centimeter, with extremes of 5 and 18 cm. Cure was by mesh in 35 cases (68.63%) and by aponeuroplasty in 16 cases (31.37%). Postoperative recovery was straightforward in 49 patients (96.1%), with two cases of surgical site infection (3.9%). The average length of stay was 11.18±3.76 days. Conclusion: Eventrations are an increasingly frequent complication of conventional surgery (laparotomy). Treatment is essentially surgical. Progress in prosthetic techniques has reduced the risk of recurrence.
VL - 13
IS - 4
ER -
Yawo, K. S., Kokolype, T., Adama, K., Alpha, D., Mohamed, K., et al. (2025). Management of Postoperative Hernias in Resource-limited Countries (Guinea). Journal of Surgery, 13(4), 112-115. https://doi.org/10.11648/j.js.20251304.17
Yawo, K. S.; Kokolype, T.; Adama, K.; Alpha, D.; Mohamed, K., et al. Management of Postoperative Hernias in Resource-limited Countries (Guinea). J. Surg.2025, 13(4), 112-115. doi: 10.11648/j.js.20251304.17
Yawo KS, Kokolype T, Adama K, Alpha D, Mohamed K, et al. Management of Postoperative Hernias in Resource-limited Countries (Guinea). J Surg. 2025;13(4):112-115. doi: 10.11648/j.js.20251304.17
@article{10.11648/j.js.20251304.17,
author = {Kondano Saa Yawo and Thea Kokolype and Konate Adama and Douno Alpha and Kaba Mohamed and Balde Fatoumata Lamarana and Diallo Mamadou Malipha and Fofana Naby and Diakite Sandaly and Fofana Houssein and Soumaoro Labile Togba and Toure Aboubacar},
title = {Management of Postoperative Hernias in Resource-limited Countries (Guinea)
},
journal = {Journal of Surgery},
volume = {13},
number = {4},
pages = {112-115},
doi = {10.11648/j.js.20251304.17},
url = {https://doi.org/10.11648/j.js.20251304.17},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20251304.17},
abstract = {Aim: the aim of the study was to contribute to the improvement of the management of ventrations in the general surgery department of CHU Ignace Deen. Material and methods: One-year retrospective descriptive study (January to December 2024), conducted in the general surgery department of CHU Ignace Deen. All complete patient records (medical observation, operative report and follow-up) admitted and operated on in the general surgery department during the study period were included. The variables studied were sociodemographic, clinical, therapeutic and evolutionary. Results: Out of 1,398 procedures performed, we recorded 51 cases of postoperative ventralization, representing 3.65% of the department's total activity. The mean age was 38.13±13.96 years, with extremes of 19 and 72 years. The 29 to 38 age group was the most represented (31.4%). Females predominated, with a sex-ratio of 0.5. Appendectomy (37.3%) and Caesarean section (29.4%) were the procedures most likely to result in ventricular deviations. Fourteen patients were referred (27.5%) and three were admitted as emergencies (5.9%). Abdominal swelling was the main reason for consultation (92.2%), and was located median subumbilically (41.2%). The mean diameter was 11.2±3.8 centimeter, with extremes of 5 and 18 cm. Cure was by mesh in 35 cases (68.63%) and by aponeuroplasty in 16 cases (31.37%). Postoperative recovery was straightforward in 49 patients (96.1%), with two cases of surgical site infection (3.9%). The average length of stay was 11.18±3.76 days. Conclusion: Eventrations are an increasingly frequent complication of conventional surgery (laparotomy). Treatment is essentially surgical. Progress in prosthetic techniques has reduced the risk of recurrence.},
year = {2025}
}
TY - JOUR
T1 - Management of Postoperative Hernias in Resource-limited Countries (Guinea)
AU - Kondano Saa Yawo
AU - Thea Kokolype
AU - Konate Adama
AU - Douno Alpha
AU - Kaba Mohamed
AU - Balde Fatoumata Lamarana
AU - Diallo Mamadou Malipha
AU - Fofana Naby
AU - Diakite Sandaly
AU - Fofana Houssein
AU - Soumaoro Labile Togba
AU - Toure Aboubacar
Y1 - 2025/08/19
PY - 2025
N1 - https://doi.org/10.11648/j.js.20251304.17
DO - 10.11648/j.js.20251304.17
T2 - Journal of Surgery
JF - Journal of Surgery
JO - Journal of Surgery
SP - 112
EP - 115
PB - Science Publishing Group
SN - 2330-0930
UR - https://doi.org/10.11648/j.js.20251304.17
AB - Aim: the aim of the study was to contribute to the improvement of the management of ventrations in the general surgery department of CHU Ignace Deen. Material and methods: One-year retrospective descriptive study (January to December 2024), conducted in the general surgery department of CHU Ignace Deen. All complete patient records (medical observation, operative report and follow-up) admitted and operated on in the general surgery department during the study period were included. The variables studied were sociodemographic, clinical, therapeutic and evolutionary. Results: Out of 1,398 procedures performed, we recorded 51 cases of postoperative ventralization, representing 3.65% of the department's total activity. The mean age was 38.13±13.96 years, with extremes of 19 and 72 years. The 29 to 38 age group was the most represented (31.4%). Females predominated, with a sex-ratio of 0.5. Appendectomy (37.3%) and Caesarean section (29.4%) were the procedures most likely to result in ventricular deviations. Fourteen patients were referred (27.5%) and three were admitted as emergencies (5.9%). Abdominal swelling was the main reason for consultation (92.2%), and was located median subumbilically (41.2%). The mean diameter was 11.2±3.8 centimeter, with extremes of 5 and 18 cm. Cure was by mesh in 35 cases (68.63%) and by aponeuroplasty in 16 cases (31.37%). Postoperative recovery was straightforward in 49 patients (96.1%), with two cases of surgical site infection (3.9%). The average length of stay was 11.18±3.76 days. Conclusion: Eventrations are an increasingly frequent complication of conventional surgery (laparotomy). Treatment is essentially surgical. Progress in prosthetic techniques has reduced the risk of recurrence.
VL - 13
IS - 4
ER -
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