COMPARATIVE OUTCOMES OF SUBLAY AND ONLAY MESH TECHNIQUES IN PARA-UMBILICAL REPAIR

Abstract

Objectives: To analyze and contrast the clinical outcomes of Sublay and Onlay mesh repair in patients undergoing surgery for para-umbilical hernia.

Study Design: Prospective comparative study.

Place and Duration of Study: Department of Surgery, Combined military Hospital, Rawalpindi

Methodology: A total of 52 patients with para-umbilical hernia were initially enrolled. After excluding seven cases due to incomplete follow-up, the final dataset consisted of 45 patients, with 21 undergoing Sublay mesh repair and 24 receiving Onlay repair. Demographic and perioperative data were recorded, and patients were followed for recurrence and postoperative complications. Chi-square and independent t-tests were applied for statistical evaluation, and a p-value less than 0.05 was taken as the threshold for significance.

Results: Baseline demographic characteristics and comorbid conditions were comparable between the two groups. The mean operative time was similar, measuring 130.7 ± 31.1 minutes in the Sublay group and 134.8 ± 36.0 minutes in the Onlay group (p = 0.684). Length of hospital stay, however, was significantly reduced in patients undergoing Sublay repair (4.4 ± 1.7 days) compared to those treated with Onlay repair (6.3 ± 3.2 days; p = 0.023). Although postoperative pain scores tended to be lower in the Sublay group, the difference was statistically non-significant (p = 0.156). Notably, no recurrences were documented in the Sublay group, whereas three cases (12.5%) occurred following Onlay repair (p = 0.041). Other postoperative complications, including wound infection, seroma, hematoma, and wound dehiscence, were observed at comparable rates in both groups without significant differences.

Conclusions: Sublay mesh repair demonstrated superior outcomes with respect to length of hospital stay and recurrence, while maintaining comparable safety profiles