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

• Published in: World journal of surgery 2015-11, Vol.39 (11), p.2622-2629
• Main Authors: Gil, José, Rodriguez, J. M., Gil, E., Hernández Agúera, Q., González, F. M., García, J. A., Balsalobre, M. D., Tortosa, J. A., Hernández Palazón, D., Diallo, A. B., Parrilla, P.
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Africa South of the Sahara; Cardiac Surgery; Female; General Surgery; Hernia Repair; Hernia, Inguinal - surgery; Humans; Inguinal Hernia; International Cooperation; Local Health Worker; Male; Medicine; Medicine & Public Health; Metamizole; Middle Aged; Original Scientific Report; Quality-Adjusted Life Years; Spinal Anesthesia; Surgery; Surgical Mesh; Thoracic Surgery; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-015-3161-y

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.