Hernia repair in patients with chronic liver disease - A 15-year single-center experience

Petro, Clayton C.; Haskins, Ivy N.; Perez, Arielle J.; Tastaldi, Luciano; Strong, Andrew T.; Ilie, Ramona; Tu, Chao; Krpata, David M.; Prabhu, Ajita S.; Eghtesad, Bijan; Rosen, Michael J.

doi:10.1016/j.amjsurg.2018.10.020

Cited by 22 publications

(21 citation statements)

References 21 publications

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“…Patients' characteristics are shown in Table 2. Mean patients’ age was 65.52 ± 11.06 years and median MELD was 12 [[6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24]]. All variables were similar between the two groups, except for number of patients in LT waiting list, which was higher in the elective hernia repair groups.…”

Section: Resultsmentioning

confidence: 99%

“…Modern surgical technique and perioperative care have been reported to improve morbity and mortality rates, justifying early repair before complications arise. Emergency operations have been reported as preditors for worse outcome as well as higher CTP and MELD scores [13,21,22]. Interestingly, morbidity increass 3% for each additional MELD point above 15 [13].…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, morbidity increass 3% for each additional MELD point above 15 [13]. Morbidity and mortality rates for elective and emergency procedures ranges from 7.4 to 27%/3.4–3.7% and 44–60% and 10–29% [21,22]. Moreover, non-operative treatment for abdominal hernias also impairs quality of life [6,23].…”

Section: Discussionmentioning

confidence: 99%

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Abdominal hernias in cirrhotic patients: Surgery or conservative treatment? Results of a prospective cohort study in a high volume center: Cohort study

Pinheiro

Andraus

Waisberg

et al. 2020

Annals of Medicine and Surgery

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BackgroundSurgical treatment of abdominal hernias in cirrhotics is often delayed due to the higher morbidity and mortality associated with the underlying liver disease. Some patients are followed conservatively and only operated on when complications occur (“wait and see” approach). The aim of this study is to compare outcomes of cirrhotic patients undergoing conservative non-operative care or elective hernia repair.MethodsA prospective observational study including 246 cirrhotic patients with abdominal hernia was carried out. Patients were given the option to select their treatment: elective hernia repair or conservative non-operative care. Demographics, characteristics of underlying liver disease, type of hernia, complications and mortality were analyzed. During follow-up of patients who opted for the “wait and see” approach, emergency hernia repair was performed in case of hernia complications.ResultsElective hernia repair was performed in 57 patients and 189 patients were kept in conservative care, of which 43 (22.7%) developed complications that required emergency hernia repair. Elective surgery provided better five-years survival than conservative care (80% vs. 62%; p = 0.012). Multivariate analysis identified multiples hernias [Hazards Ratio (HR):6.7, p < 0.001] and clinical follow-up group (HR 3.62, p = 0.005) as risk factors for mortality. Among patients undergoing surgical treatment, multivariate analysis revealed MELD>11 (HR 7.8; p = 0.011) and emergency hernia repair (HR 5.35; p = 0.005) as independent risk factors for 30-day mortality.ConclusionsElective hernia repair offers an acceptable morbidity and ensures longer survival. “Wait and see” approach jeopardizes cirrhotic patients and should be avoided, given the higher incidence of emergency surgery due to hernia complications.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Abdominal hernias in cirrhotic patients: Surgery or conservative treatment? Results of a prospective cohort study in a high volume center: Cohort study

Pinheiro

Andraus

Waisberg

et al. 2020

Annals of Medicine and Surgery

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“…Baseline characteristics such as age and selected comorbidities were considered risk factors for the diagnosis of IH. We included hypertension [29], kidney disease [30], diabetes mellitus [31], liver disease [32], obesity [33], chronic obstructive pulmonary disease [34] and urethral disease [35] as potential confounders. Log-rank tests were used to compare differences in the cumulative incidence of IH between men with and without LUTS-BPH.…”

Section: Discussionmentioning

confidence: 99%

Lower urinary tract symptoms–Benign prostatic hyperplasia may increase the risk of subsequent inguinal hernia in a Taiwanese population: A nationwide population-Based cohort study

Juan

Shen

et al. 2020

PLoS ONE

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Introduction & objectivesIt has been suggested that lower urinary tract symptoms-benign prostatic hyperplasia (LUTS-BPH) may be a risk factor for inguinal hernia (IH). The aim of this study was to examine the emergence of a subsequent IH diagnosis in men with and without LUTS-BPH. MethodsFrom a database derived from the National Health Insurance Program covering 99% of the population in Taiwan, 22,310 men with LUTS-BPH and 22,310 matched men without LUTS-BPH were identified and followed for IH from 1997 to 2013. Both IH and LUTS-BPH were defined by the ninth revision of the International Classification of Diseases code (ICD9). Subjects younger than 20 years of age and with IH diagnosed before the index date were excluded. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) for subsequent IH, controlling for potential confounders. ResultsMen with and without LUTS-BPH had similar age and comorbidity distributions. During the 10 years of follow-up, 1,303 (5.84%) men with LUTS-BPH and 735 (2.53%) men without LUTS-BPH developed IH. The mean time to IH was 4.02 years and 4.44 years, respectively. After adjusting for age and comorbidities, LUTS-BPH was associated with a two-fold increased risk of IH (HR:2.25, 95% CI = 2.04-2.49).

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“…Ventral hernia (VH) is a non-inguinal, non-hiatal defect in the fascia of the abdominal wall. VH repair is a commonly performed procedure (Cho et al, 2019;Petro et al, 2019). One-third (by physical examination) to one-half (by radiographic imaging) of all individuals have a ventral hernia (Poulose et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Herniography of Small Sized Midline Ventral Hernias in Day Surgery Unit Results in Academic Teaching Hospital

Abdel-Fatah¹,

Fatah²,

Saad³

et al. 2020

MJMR

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Background: Repair of ventral hernia (VH) is a commonly performed procedure. The purpose of this study is to evaluate the results of primary repair of midline VH using laparoscopic approach as a day surgery procedure in an academic teaching hospital. Material and methods: This prospective study was conducted in General Surgery department, Minia University Hospital, Egypt, for 82 patients with midline ventral hernias subjected to primary repair of the defect using laparoscopic approach in the period from February 2017 till February 2019. Patients were followed up for seroma, hematoma, wound infection or recurrence. Results: Study included 81 patients; 30 cases (37%) were males and 51 (63%) were females. Ages ranged from 20-57 years. Thirty-eight (46.9%) patients presented with epigastric hernias, 34 (42%) had paraumbilical hernias, and port site hernias were found in 9 (11.1%) patients. Mean width of the defect was 15 ± 4.3 mm. Mean operative time was 52.3 min. All cases were done on a day surgery setting. No cases showed intestinal injury or paralytic ileus. Eighteen patients (22.2%) developed seroma not requiring aspiration. Hematoma was seen in three (3.7%) patients and was conservatively managed. Only two cases (2.5%) developed superficial wound infection. Rate of recurrence was 4.9%. Conclusion: Primary laparoscopic ventral hernia repair (LVHR) with defects less than 2 cm in diameter is a safe, simple, time-saving procedure associated with less complications, less risk of surgical site infection (SSI), shorter hospital stay and low cost.

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Hernia repair in patients with chronic liver disease - A 15-year single-center experience

Cited by 22 publications

References 21 publications

Abdominal hernias in cirrhotic patients: Surgery or conservative treatment? Results of a prospective cohort study in a high volume center: Cohort study

Abdominal hernias in cirrhotic patients: Surgery or conservative treatment? Results of a prospective cohort study in a high volume center: Cohort study

Lower urinary tract symptoms–Benign prostatic hyperplasia may increase the risk of subsequent inguinal hernia in a Taiwanese population: A nationwide population-Based cohort study

Laparoscopic Herniography of Small Sized Midline Ventral Hernias in Day Surgery Unit Results in Academic Teaching Hospital

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