title: Button hole hernioplasty: A new technique for treatment of umblical hernia in cirrhotic patients. A prospective follow up study.
abstract: BACKGROUND
  Surgical treatment of umbilical hernia in cirrhotic patients is still an interesting topic in many studies to achieve the best method of treatment. These patients are liable to many surgical and medical risks.
  
  
  OBJECTIVE
  to evaluate the surgical outcome as well as the postoperative course of Button hole hernioplasty as a simple, safe, and effective new technique for hernia repair in cirrhotic patients.
  
  
  METHODS
  Forty cirrhotic patients with uncomplicated umbilical hernia were included in this study through collaboration between Departments of General Surgery and Tropical Medicine and Gastroenterology, Assiut University Hospital, Assiut, during one year period. Patients were categorized according to the severity of liver cirrhosis into three groups (A, B, and C). Patients were subjected to an elective hernioplasty after adjustment of the disturbed medical and biochemical factors.
  
  
  RESULTS
  There was a significant difference in operative time, hospital stay, and prothrombine (time and concentration) among the three groups (p < 0.05). The three parameters were longest in group C when compared to the other two groups. No severe complications were recorded except in only one case. Also, no recurrence, no morbidities or deaths were recorded after 6 months follow-up.
  
  
  CONCLUSIONS
  Button hole hernioplasty is a new simple surgical technique for treatment of umbilical hernia in cirrhotic patients with no significant complications.
authors.affiliation: Faculty of Medicine, Assiut University, Egypt; Department of General Surgery, Assiut University Hospital 71111, Assiut, Egypt. Electronic address: kottb73@yahoo.com.
authors.forename: Mohamed B M
authors.initials: MB
authors.lastname: Kotb
authors.affiliation: Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Assiut University, Egypt. Electronic address: momar7619@gmail.com.
authors.forename: Mohamed O
authors.initials: MO
authors.lastname: Abdel-Malek
authors.affiliation: Pediatric Surgery Unit, Surgical Department, Assiut University Children Hospital, Assiut, Egypt. Electronic address: almoutazeltayeb@hotmail.com.
authors.forename: Almoutaz A
authors.initials: AA
authors.lastname: Eltayeb
authors.affiliation: Faculty of Medicine, Assiut University, Egypt; Department of General Surgery, Assiut University Hospital 71111, Assiut, Egypt. Electronic address: g_makhlouf@yahoo.com.
authors.forename: Gamal A
authors.initials: GA
authors.lastname: Makhlouf
authors.affiliation: Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Assiut University, Egypt. Electronic address: nahedmak@yahoo.com.
authors.forename: Nahed A
authors.initials: NA
authors.lastname: Makhlouf
mesh_terms: D000328:Adult; D000368:Aged; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006554:Hernia, Umbilical / Q000150:complications / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies; D012008:Recurrence; D013526:Surgical Mesh; D055815:Young Adult
keywords: Button hole; Cirrhosis; Hernia