Incidence and predisposing factors for incisional hernia in patients with liver transplantation

被引：1

作者：

Gomez R. ^{[1
]}

Hidalgo M. ^{[1
]}

Marques E. ^{[1
]}

Marin L. ^{[1
]}

Loinaz C. ^{[1
]}

Gonzalez I. ^{[1
]}

Garcia I. ^{[1
]}

Moreno E. ^{[1
]}

机构：

[1] Serv. of Digest. Surg./Abdom. Organ, University Hospital 12 de Octubre, Madrid, 2805

来源：

Hernia | 2001年 / 5卷 / 4期

关键词：

Incisional hernia; Liver transplantation; Prosthetic mesh; Surgery;

D O I：

10.1007/s10029-001-0032-2

中图分类号：

学科分类号：

摘要：

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.

引用

页码：172 / 176

页数：4

共 25 条

[1]

Adloff M., Arnaud J.P., Surgical management of large incisional hernias by an intraperitoneal mersilene mesh and an aponeurotic graft, Surg Gynecol Obstet, 165, pp. 204-206, (1987)

[2]

Bang R.L., Behbehani A., Repair of large, multiple, and recurrent ventral hernias: An analysis of 124 cases, Eur J Surg, 163, pp. 107-114, (1997)

[3]

Bucknall T.E., Cox P.J., Ellis H., Burst abdomen and incisional hernia: A prospective study of 1129 major laparotomies, Br M J, 284, pp. 931-933, (1982)

[4]

Bucknall T., Ellis H., Abdominal wound closure - A comparison of monofilament nylon and polyglycolic acid, Surgery, 89, pp. 672-677, (1981)

[5]

Ellis H., Gajraj H., George C.D., Incisional hernias: When do they occur?, Br J Surg, 70, pp. 290-291, (1983)

[6]

Gomez R., Moreno E., Colina F., Loinaz C., Gonzalez I., Lumbreras C., Perez-Cerda F., Castellon C., Garcia I., Steroid withdrawal is safe and beneficial in stable cyclosporine-treated liver transplant patients, J Hepatol, 28, pp. 150-156, (1998)

[7]

Guillou P.J., Hall T., Donaldson D.R., Broughton A.C., Brennan T.G., Vertical abdominal incisions - A choice?, Br J Surg, 67, pp. 395-399, (1980)

[8]

Hesselink V.J., Luijendijk R.W., De Wilt J.H.W., Heide R., Jeekel J., An evaluation of risk factors in incisional hernia recurrence, Surg Gynecol Obstet, 176, pp. 228-234, (1993)

[9]

Israelsson L., Jonsson T., Incisional hernia after midline laparotomy: A prospective study, Eur J Surg, 162, pp. 125-129, (1996)

[10]

Israelsson L., Jonsson T., Overweight and healing of midline incisions: The importance of suture technique, Eur J Surg, 163, pp. 175-180, (1997)

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