eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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1/2018
vol. 13
 
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abstract:
Original paper

Ethnicity-related differences in inguinal canal dimensions between African and Caucasian populations and their potential impact on the mesh size for open and laparoscopic groin hernia repair in low-resource countries in Africa

Kryspin Mitura, Sławomir Kozieł, Michał Pasierbek

Videosurgery Miniinv 2018; 13 (1): 74–81
Online publish date: 2018/01/04
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Introduction
Access to surgery in Africa is significantly limited. Treatment outcomes in Africa differ significantly compared to those achieved in Europe or the US. Therefore, to popularise tension-free repair, it is essential to determine the economically justified mesh size for the African population.

Aim
To conduct anthropometric evaluation of the inguinal canal in African and European patients to determine its potential consequences for the mesh size for open and laparoscopic hernia repair.

Material and methods
The measurements were made in 44 adult males in Africa (group I) and were compared to measurements in 45 consecutive Caucasian males (group II). The mean age of patients was respectively 48.3 and 51.2 years.

Results
There was no statistically significant difference in the internal ring diameter between groups (2.2 vs. 2.1 cm; p = 0.58). The distance between the pubic tubercle and the inferomedial border of the internal inguinal ring was significantly shorter in group I (3.8 vs. 5.1 cm; p < 0.001). A similar difference was found in the length of transverse arch aponeurosis (2.9 vs. 4.0 cm; p < 0.001). The distance between the pubic tubercle and anterior superior iliac spine in group I was approximately 2 cm shorter on each side (10.0 vs. 11.8 cm; p < 0.001).

Conclusions
The anatomical differences in inguinal dimensions between Central African and European populations support the potential need to adjust the standard size of synthetic mesh used for hernia repair to the needs of local populations. The significantly smaller dimensions of the inguinal canal in African males may allow the use of smaller meshes.

keywords:

Africa, inguinal canal, hernia repair, mesh size, low-resource country

references:
Dare L, Buch E. The future of health care in Africa. Br Med J 2005; 331: 1-2.
Lucas AO. Human resources for health in Africa. Br Med J 2005; 331: 1037-8.
Sanders DL, Kingsnorth AN. Operation hernia: humanitarian hernia repairs in Ghana. Hernia 2007; 11: 389-91.
Kingsnorth AN, Oppong C, Akoh J, et al. Operation hernia to Ghana. Hernia 2006; 10: 376-9.
Nordberg EM. Incidence and estimated need of caesarean section, inguinal hernia repair and operation for strangulated hernia in rural Africa. Br Med J 1984; 289: 92-3.
Ferraz de Carvalho CA, Souza RR, Fernandes PMP. The relationship between anthropometric parameters and measurements of the human inguinal region. Surg Radiol Anat 1987; 9: 281-5.
Abdalla RZ, Mittelstaedt WE. The importance of the size of Hessert’s triangle in the etiology of inguinal hernia. Hernia 2001; 5: 119-23.
Sanders DL, Porter CS, Mitchell KCD, et al. A prospective cohort study comparing the African and European hernia. Hernia 2008; 12: 527-9.
Ohene-Yeboah M. Strangulated external hernias in Kumansi. West Afr Med J 2003; 22: 310-3.
Primatesta P, Goldacre MJ. Inguinal hernia repair: incidence of elective and emergency surgery, readmission and mortality. Int J Epidemiol 1996; 25: 502-9.
Mitura K, Kozieł S, Pasierbek M. Groin hernia surgery in northern Ghana – humanitarian mission of Polish surgeons in Tamale. Pol Przegl Chir 2015; 87: 16-21.
Handa VL, Lockhart ME, Fielding JR, et al. Racial differences in pelvic anatomy by magnetic resonance imaging. Obstet Gynecol 2008; 111: 914-20.
Baragi RV, Delancey JO, Caspari R, et al. Differences in pelvic floor area between African American and European American women. Obstet Gynecol 2002; 187: 111-5.
Letterman GS. The greater sciatic notch in American Whites and Negroes. Am J Phys Anthropol 1941; 28: 99-116.
DiBennardo R, Taylor JV. Multiple discriminant function analysis of sex and race in the postcranial skeleton. Am J Phys Anthropol 1983; 61: 305-14.
Patriquin ML, Steyn M. Metric analysis of sex differences in South African black and white pelves. Forensic Sci Int 2005; 147: 119-27.
Steyn M, Iscan MY. Metric sex determination from the pelvis in modern Greeks. Forensic Sci Int 2008; 179: 86.e1-6.
Peri G, Farina F, Marciano V, et al. Clinical and anatomic features of the inguinal canal during hernia. Ital J Anat Embryol 1996; 101: 69-80.
Ledinsky M, Matejcic A, De Syo D, et al. Some structural characteristics of the inguinal region in the Northern Croatia. Coll Antropol 1998; 22: 515-24.
Zinanovic S. The anatomical basis for the high frequency of the inguinal and femoral hernia in Uganda. East Afr Med J 1968; 45: 41-6.
Lopez-Cano M, Munhequete EG, Hermosilla-Perez E. Anthropometric characteristics of the pubic arch and proper function of the defense mechanisms against hernia formation. Hernia 2005; 9: 56-61.
Rabe R, Yacapin CPR, Buckley BS, et al. Repeated in vivo inguinal measurements to estimate a single optimal mesh size for inguinal herniorrhaphy. BMC Surgery 2012; 12: 19.
Pawlak M, Bury K, Smietanski M. The management of abdominal wall hernias – in search of consensus. Videosurgery Miniinv 2015; 10: 49-56.
Klobusicky P, Hoskovec D. Reduction of chronic post-herniotomy pain and recurrence rate. Use of the anatomical self-gripping ProGrip laparoscopic mesh in TAPP hernia repair. Preliminary results of a prospective study. Videosurgery Miniinv 2015; 10: 373-81.
Koziel S, Mitura K, Papaj P, et al. Tension-free mosquito net mesh inguinal hernioplasty – an alternative exclusively for the Third World? Pol Przegl Chir 2015; 87: 102-7.
Mitura K, Romanczuk M. Redundant modifications of Lichtenstein technique in hernia repair – a descriptive study of practising surgeons in Poland. Videosurgery Miniinv 2009; 4: 1-5.
Amid PK. The Lichtenstein in 2002: an overview of causes of recurrence after Lichtenstein tension-free hernioplasty. Hernia 2003; 7: 13-6.
  
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