Gianluca Cassese1, Antonio Castaldi1,2, Bader Al Taweel2, Moglie Le Quintrec3, Rodolphe Thuret4, Francis Navarro2, Fabrizio Panaro5. 1. Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy. 2. Department of HPB Surgery and Liver Transplantation, Montpellier University Hospital-School of Medicine, 34000, Montpellier, France. 3. Department of Nephrology and Kidney Transplantation, Montpellier University Hospital, Montpellier, France. 4. Department of Urology and Kidney Transplantation, Montpellier University Hospital, Montpellier, France. 5. Department of HPB Surgery and Liver Transplantation, Montpellier University Hospital-School of Medicine, 34000, Montpellier, France. f-panaro@chu-montpellier.fr.
Abstract
BACKGROUND AND AIM: Incisional hernia (IH) after Kidney Transplantation (KT) is a challenging complication due to both technical reasons and patients' complexity. Data regarding outcomes of hernia repair in KT recipients are uncertain, since the biggest part of previous papers focused on risk factors for incisional hernia occurrence and not on its outcomes. Aim of the study was to focus on risk factors for incisional hernia recurrence after surgical repair in KT recipients. METHODS: Data regarding all consecutive patients undergoing kidney transplantations from January 2011 until September 2020 in Montpellier University Hospital were retrospectively collected from a single institutional database. RESULTS: After a median follow-up of 48 months (IQR25-75 31-59), data from 1546 consecutive KT were collected. 83 patients underwent 99 incisional hernia surgeries after KT, with 14 patients that had one recurrence (14.4%) and 2 patients that experienced two recurrences (2.4%). Total recurrence rate was 16.8%. At univariate analysis, the only factor associated with an incisional hernia recurrence was having undergone to at least one previous abdominal surgery other than KT (p value 0.002). Overall morbidity was 15% (n = 15), with most of complications classified as mild (59%). No mortality related to incisional hernia repair occurred. CONCLUSION: IHs after KT represent an important condition. Its surgical management is challenging due to its anatomical complexity and patient's status. This is the largest sample size in the literature of patients treated for IH after KT and it shows that a previous surgery other than the KT is a risk factor for hernia recurrence after surgical repair, without regarding surgical technique or other comorbidity and therapeutical factors.
BACKGROUND AND AIM: Incisional hernia (IH) after Kidney Transplantation (KT) is a challenging complication due to both technical reasons and patients' complexity. Data regarding outcomes of hernia repair in KT recipients are uncertain, since the biggest part of previous papers focused on risk factors for incisional hernia occurrence and not on its outcomes. Aim of the study was to focus on risk factors for incisional hernia recurrence after surgical repair in KT recipients. METHODS: Data regarding all consecutive patients undergoing kidney transplantations from January 2011 until September 2020 in Montpellier University Hospital were retrospectively collected from a single institutional database. RESULTS: After a median follow-up of 48 months (IQR25-75 31-59), data from 1546 consecutive KT were collected. 83 patients underwent 99 incisional hernia surgeries after KT, with 14 patients that had one recurrence (14.4%) and 2 patients that experienced two recurrences (2.4%). Total recurrence rate was 16.8%. At univariate analysis, the only factor associated with an incisional hernia recurrence was having undergone to at least one previous abdominal surgery other than KT (p value 0.002). Overall morbidity was 15% (n = 15), with most of complications classified as mild (59%). No mortality related to incisional hernia repair occurred. CONCLUSION: IHs after KT represent an important condition. Its surgical management is challenging due to its anatomical complexity and patient's status. This is the largest sample size in the literature of patients treated for IH after KT and it shows that a previous surgery other than the KT is a risk factor for hernia recurrence after surgical repair, without regarding surgical technique or other comorbidity and therapeutical factors.
Authors: G Merola; G Cavallaro; O Iorio; M Frascio; E Pontecorvi; F Corcione; J Andreuccetti; G Pignata; C Stabilini; U Bracale Journal: Hernia Date: 2019-11-22 Impact factor: 4.739
Authors: Leonard F Kroese; Jean-Francois Gillion; Johannes Jeekel; Gert-Jan Kleinrensink; Johan F Lange Journal: Int J Surg Date: 2018-02-20 Impact factor: 6.071