Management of umbilical hernia complicated with liver cirrhosis: An advocate of early and elective herniorrhaphy

Choi, Sae Byeol; Hong, Kwang Dae; Lee, Jin Suk; Han, Hogyu; Kim, Wan Bae; Song, Tae Jin; Suh, Soon Yong; Kim, Young Chul; Choi, Sang Yong

doi:10.1016/j.dld.2011.07.015

Cited by 54 publications

(51 citation statements)

References 18 publications

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“…However, recent reports for elective repair are more promising, and there is tendency to perform elective repair to avoid emergency surgery for complications associated with very high mortality and morbidity rates (48,49). Early elective repair of umbilical hernias in patients with cirrhosis is advocated considering the hepatic reserve and patient's condition (50). Ascites control is the mainstay of post-operative management.…”

Section: Factors Influencing Recurrencementioning

confidence: 99%

Current options in umbilical hernia repair in adult patients

Kulaçoğlu¹

2015

UCD

104

126

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Umbilical hernia is a rather common surgical problem. Elective repair after diagnosis is advised. Suture repairs have high recurrence rates; therefore, mesh reinforcement is recommended. Mesh can be placed through either an open or laparoscopic approach with good clinical results. Standard polypropylene mesh is suitable for the open onlay technique; however, composite meshes are required for laparoscopic repairs. Large seromas and surgical site infection are rather common complications that may result in recurrence. Obesity, ascites, and excessive weight gain following repair are obviously potential risk factors. Moreover, smoking may create a risk for recurrence.

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Section: Factors Influencing Recurrencementioning

confidence: 99%

Current options in umbilical hernia repair in adult patients

Kulaçoğlu¹

2015

UCD

104

126

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“…Other studies have also suggested elective umbilical herniorrhaphy in cirrhotic patients and described superior results over conservative management to avoid complications associated with this kind of management [20,21].…”

Section: Discussionmentioning

confidence: 99%

“…Indication, timing, and technical aspects of herniorrhaphy in these patients also remain controversial [20].…”

Section: Discussionmentioning

confidence: 99%

Patient Optimization is the Key in Surgical Repair of Ruptured Umblical Hernia in Cirrhotic Patients and Tense Ascitis

Abbas¹,

Elhadidi²,

Abdel-Aziz³

et al. 2017

Hernia

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Background: Ulceration, leakage, and rupture are considered as the most common complications of umbilical hernias in patients with refractory ascites due to advanced cirrhosis. We aim to determine optimal management and outcome after umbilical herniorrhaphy or hernioplasty in those patients. Methods:A retrospective chart review was performed on 37 patients with advanced cirrhosis who underwent umbilical herniorrhaphy or hernioplasty at our hospital.Results: A total of 37 patients (12 female, 32.4%) had refractory ascites, with mean age of 52.2 ± 7.7 years (ranging from 37 to 70 years), 30 presented with leaking luid, 5 with ulceration, and only 2 with spontaneous umbilical rupture. A total of 33 (89.2%) required perioperative human albumin transfusion, and only 7 (18.9%) required perioperative paracentesis. Only ive patients (13.5%) required preoperative platelets transfusion.Propylene mesh was used in seven (18.9%) cases. Eleven patients (29.7%) developed ascites-related wound complications. Leaking ascites was recorded in three cases (8.1%) and only one case (2.7%) developed wound dehiscence and required reoperation. Hematemesis and melena were recorded in three (8.1%) early post operative without renal deterioration or encephalopathy. No early postoperative mortality. Conclusion:With meticulous preoperative patient optimization, management of ruptured umbilical hernias in patients with advanced hepatic cirrhosis and refractory ascites is feasible.

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“…Elective repair of umbilical hernias has been well advocated [172,177,181,182] even with CTP B and C patients and decompensated cirrhosis [183,184], while conservative management results in higher complication rates 60-80% [185].…”

Section: Herniamentioning

confidence: 99%

“…[172,173] Historically in LC, overall mortality was 5%, 11% after emergency surgery, and 2% after elective surgery, with an 8-14% recurrence rate [134,174].…”

Section: Herniamentioning

confidence: 99%

Perioperative Risk Assessment and Management of Cirrhotic Patients

AL¹,

Dong²,

Nayi³

2015

J Hepatol Gastroint Dis

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Liver cirrhosis is an important risk factor for morbidity and mortality in any type of surgical procedure. For these patients, a distinct and tailored patient optimization approach prior to surgery is required in order to best risk mitigate towards avoiding decompensation and related complications, especially with the chronicity of this disease. This review is to enhance understanding of surgical risks in these patients in selecting patients for elective surgery, or managing those following emergency surgery.

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Management of umbilical hernia complicated with liver cirrhosis: An advocate of early and elective herniorrhaphy

Cited by 54 publications

References 18 publications

Current options in umbilical hernia repair in adult patients

Current options in umbilical hernia repair in adult patients

Patient Optimization is the Key in Surgical Repair of Ruptured Umblical Hernia in Cirrhotic Patients and Tense Ascitis

Perioperative Risk Assessment and Management of Cirrhotic Patients

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