Polypropylene mesh repair of incisional hernia after kidney transplantation: Single-center experience and review of the literature

Varga, M; Matia, Ivan; Kučera, Miloš; Oliverius, Martin; Adamec, M

doi:10.12659/aot.882004

Cited by 35 publications

(38 citation statements)

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“…This is similar to rates reported by Mazzucchi (3.8%) [8]. Several other studies report rates as low at 1.6% [9, 23]. One author reported incisional hernia rates of 18% with the use of Sirolimus [10].…”

Section: Discussionsupporting

confidence: 84%

Incidence and risk factors of incisional hernia formation following abdominal organ transplantation

et al. 2014

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Background Hernia formation is common following abdominal operations and transplant patients are at increased risk due to their need for postoperative immunosuppression. The purpose of this study is to estimate the incidence of incisional hernia formation following primary abdominal solid organ transplantation and identify clinical risk factors for hernia formation. Methods We performed a single-institution retrospective review of a prospectively collected database to evaluate all patients who underwent primary liver, kidney, or pancreas transplantation between 2000 and 2011. The primary outcome measure was hernia formation at the transplant incision. Univariate and multivariate Cox proportional hazards models were used to identify risk factors for incisional hernia formation. Results 3460 transplants were performed during the study period: 2247 kidney only, 718 liver only, and 495 pancreas or simultaneous pancreas and kidney (pancreas group). The overall incisional hernia rate was 7.5%. The Kaplan-Meier rates of hernia formation at 1, 5, and 10 years were 2.5%, 4.9%, and 7.0% for kidney; 4.5%, 13.6%, and 19.0% for liver; and 2.5%, 12.7%, and 21.8% for the pancreas groups. On univariate analysis, surgical site infection (SSI), body mass index (BMI) >25, delayed graft function (DGF), and absence of a calcineurin inhibitor or mycophenolic acid (MMF) were associated with hernia formation in the kidney group. SSI and BMI>25 were associated with hernia formation in the liver group. In the pancreas group, SSI, the use of cyclosporine, and lack of MMF were all associated with hernia formation. On multivariate analysis, SSI was strongly associated with hernia formation in all groups (Hazard Ratio (HR): Kidney = 24.71, p<0.001; Liver = 12.0, p<0.001, Pancreas = 12.95, p=0.001). Conclusion Incisional hernias are common following abdominal organ transplant with nearly one in five patients developing an incisional hernia five years after liver of pancreas transplantation. Strategies focusing on prevention and early treatment of SSI may help to decrease the risk of incisional hernia formation following abdominal organ transplantation.

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Section: Discussionsupporting

confidence: 84%

Incidence and risk factors of incisional hernia formation following abdominal organ transplantation

et al. 2014

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“…The incidence of incisional hernia is between 3% and 13% [7]. In the present case, incisional hernia developed 3 years after the renal transplantation.…”

Section: Discussionmentioning

confidence: 49%

Iatrogenic Ureteral Injury During Incisional Hernia Repair in a Kidney Recipient

et al. 2017

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Incisional hernia is not a rare complication in kidney allograft recipients, due to prolonged dialysis, immunosuppressive drugs, especially, corticosteroids, and high prevalence of diabetes mellitus. Although the use of immunosuppressive drugs increases the risk of infection with synthetic materials, using mesh to prevent hernia recurrence in patients with multiple predisposing factors is safe and necessary. Repeated surgeries cause pathological distortion of anatomy which prevents the intraoperative visibility of the ureter and increases the risk of injury. In the present case, we report a very rare ureteric injury in a patient who underwent incisional hernia repair with propylene mesh after renal transplantation.

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“…Transplant patients are more susceptible to incisional and mesh infections because of posttransplant immunosuppression; therefore, the use of preventive mesh in transplant patients is still under debate. Immunosuppressive medication following transplantation increases the risk of seroma formation and infection in KTx patients.…”

Section: Discussionmentioning

confidence: 99%

“…However, no gold standard prevention method has been agreed upon. Meshes or fascial flaps are mainly used during surgical treatment of hernias and wound and fascial dehiscence . Recently, mesh placement was investigated as a preventive method to reduce the incidence of some wound complications, including wound and fascial dehiscence and hernia after abdominal surgery .…”

Section: Introductionmentioning

confidence: 99%

Prophylactic onlay reinforcement with absorbable mesh (polyglactin) is associated with less early wound complications after kidney transplantation: A preliminary study

et al. 2019

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Incidence of wound complications after kidney transplantation (KTx) is still considerable. Here, we report the impact of prophylactic absorbable polyglactin (Vicryl®) mesh reinforcement on the incidence of short‐term post‐KTx wound complications. Sixty‐nine patients were analyzed; 23 with and 46 without preventive onlay mesh reinforcement. Surgical site infections (SSI) were seen in six (26%) patients in the mesh group and in 17 (37%) patients in no‐mesh group. A lower, but not statistically significant, rate of early postoperative wound complications occurred in the mesh group. Wound complications were observed in seven (30%) patients in the mesh group and in 23 (50%) patients in the no‐mesh group. There was no association between mesh placement and SSI incidence (odds ratios [OR] 0.60, 95% confidence interval [CI] 0.20–1.82, p = 0.369) and wound complications (OR 0.44, 95% CI 0.15–1.26, p = 0.126). Therefore, we conclude that mesh reinforcement does not increase the risk of SSI and overall wound complications. Long‐term outcomes have to be evaluated in a randomized trial setting. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 108B:67–72, 2020.

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Polypropylene mesh repair of incisional hernia after kidney transplantation: Single-center experience and review of the literature

Cited by 35 publications

References 0 publications

Incidence and risk factors of incisional hernia formation following abdominal organ transplantation

Incidence and risk factors of incisional hernia formation following abdominal organ transplantation

Iatrogenic Ureteral Injury During Incisional Hernia Repair in a Kidney Recipient

Prophylactic onlay reinforcement with absorbable mesh (polyglactin) is associated with less early wound complications after kidney transplantation: A preliminary study

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