Outpatient Treatment of Parietal Hernias in Koutiala, Mali: About 704 Cases

Purpose: To evaluate the result of outpatient treatment of parietal hernias at the Koutiala district hospital. Patients and method: This was a prospective and descriptive study taking place from August 1, 2017 to August 31, 2023. The files of patients with parietal hernia and operated on in the general surgery department at the Koutiala district hospital were collected. Result: The files of 704 patients were retained. The average age was 34 ± 25 years. We noted 285 patients under 15 years old and 84 patients over 60 years old. Men were in the majority with 92%. Patients had accommodation in the town of Koutiala in 93%. According to the topography, there were 418 cases of groin hernias, 112 cases of umbilical hernia, 18 cases of linea alba hernia, and 156 cases of patent peritoneal-vaginal canal. The surgical technique involves ligation and sectioning of the canal to resection of the sac in patients under 15 years of age and Shouldice techniques and aponeurotic closure with or without resection of the hernia sac in adult patients. The average duration of intervention was 47.9±2.2 minutes. The average time to wake up, move around and urinate were 26.5±7.2 min, 47.7±8.7 min and 96.4±18.2 min, respectively. Feeding was authorized on average for 71.2±14.3 min. The average length of hospitalization was 6 hours. Postoperatively, we noted 26 cases of scrotal edema, 8 cases of scrotal hematoma and 42 cases of parietal suppuration. Conclusion: The success of this practice requires mastery of the surgical technique and strict compliance with the selection criteria and discharge criteria.