BACKGROUND: Cirrhotic patients who are transplanted have a high risk of developing incisional hernia (IH). MATERIALS AND METHODS: We have analysed the incidence and treatment of IH in 465 patients with liver transplantation (LT). In order to find predisposing factors, we compared these patients with a similar group of patients with LT without IH. Fifty-four patients (11.6%) developed an IH. Forty-six of these (85%) were males, and in 37% the entire laparotomy incision was involved. Forty patients have been operated on for the hernia, three by primary repair and 37 (92.5%) with a polypropylene mesh. After a follow-up of 42 months, 6 (15%) IHs recurred. Comparing groups, IH patients were older (P<0.05), of male gender (P<0.001), and received more steroids (P<0.01). The IH rate was not related to suture material. CONCLUSIONS: Our rate of IH is perhaps reasonable in these high risk patients. It appears that IH can be reduced if steroids are reduced or avoided. We recommend a large mesh for repair.
BACKGROUND: Cirrhotic patients who are transplanted have a high risk of developing incisional hernia (IH). MATERIALS AND METHODS: We have analysed the incidence and treatment of IH in 465 patients with liver transplantation (LT). In order to find predisposing factors, we compared these patients with a similar group of patients with LT without IH. Fifty-four patients (11.6%) developed an IH. Forty-six of these (85%) were males, and in 37% the entire laparotomy incision was involved. Forty patients have been operated on for the hernia, three by primary repair and 37 (92.5%) with a polypropylene mesh. After a follow-up of 42 months, 6 (15%) IHs recurred. Comparing groups, IH patients were older (P<0.05), of male gender (P<0.001), and received more steroids (P<0.01). The IH rate was not related to suture material. CONCLUSIONS: Our rate of IH is perhaps reasonable in these high risk patients. It appears that IH can be reduced if steroids are reduced or avoided. We recommend a large mesh for repair.
Authors: Carter T Smith; Micah G Katz; David Foley; Bridget Welch; Glen E Leverson; Luke M Funk; Jacob A Greenberg Journal: Surg Endosc Date: 2014-08-15 Impact factor: 4.584
Authors: Lawrence Lee; Benjamin Mappin-Kasirer; Alexander Sender Liberman; Barry Stein; Patrick Charlebois; Melina Vassiliou; Gerald M Fried; Liane S Feldman Journal: Surg Endosc Date: 2012-05-12 Impact factor: 4.584