Comparison of transumbilical approach versus infraumbilical incision for the repair of umbilical hernia in adults.
BACKGROUND
Surgical management of umbilical hernias is proposed in the vast majority of cases. The typical approaches make a semilunar incision above the umbilicus. The aim of this study is evaluate the surgical approach with two different incisions, the transumbilical approach and the infra-umbilical approach.


METHODS
Included in the study were 82 consecutive patients with diagnosis of umbilical hernia. Variables related to demographic characteristics, surgical operation, and cosmetic results were evaluated. Patients were randomized into two groups; transumbilical or infra-umbilical approach. Statistical analysis was carried out to evaluate complications, recurrences and aspects of the surgical scar.


RESULTS
The study included group A (42 patients) and group B (40 patients). The most frequent symptom was pain in both groups. Complications were similar in both groups with four (9.5%) in group A and eight (19%) in group B (RR 0.53, 95% CI 0.17-1.61, p = 0.24). Cosmetic results were classified as good in the vast majority of patients in group A (p 0.001). No recurrences or mortality have been reported so far in both studied groups.


CONCLUSIONS
We described an uncommon technique of incision with the aim of improving cosmetic results. Our results are in concordance with randomized clinical trials with the same technique with no recurrence or mortality to date. Cosmetic results in our patients using the transumbilical approach were clearly superior.
Departamento de Cirugía, Medicina Familiar del Hospital General de Zona No. 1, Instituto Mexicano del Seguro Social, Colima, México. epdch@hotmail.com
Emilio
E
Prieto-Díaz Chávez
José Luis
JL
Medina-Chávez
Luis Omar
LO
Avalos-Cortes
Andrea
A
Atilano-Coral
Benjamín
B
Trujillo-Hernández
D000328:Adult; D005260:Female; D006554:Hernia, Umbilical / Q000601:surgery*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods; D014472:Umbilicus