The abdominal wall incisional hernia repair in cirrhotic patients

Licari, Leo

doi:10.11138/gchir/2018.39.1.020

Cited by 11 publications

(13 citation statements)

References 24 publications

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“…Moreover, Salamone et al identified emergency interventions, Child-Turcotte-Pugh (CTP) Class C, American Society of Anesthesiologists (ASA) physical status scores ≥3, and MELD scores ≥20 as independent risk factors by multivariate analysis for postoperative morbidity and mortality in adult cirrhotic patients undergoing incarcerated groin hernia repair. 3 Similar results were also reported by Silva et al 15 for abdominal wall herniorrhaphy in 50 patients with alcoholic cirrhosis. The cohort included 9 patients with groin hernias and 8 patients with mixed hernia types.…”

Section: Introductionsupporting

confidence: 81%

“…While umbilical hernias are encountered in up to 20% of long-standing cirrhotics and in 40% of those with persistent ascites, specific data regarding the incidence of inguinal hernias remain ill determined. 2,3…”

Section: Introductionmentioning

confidence: 99%

“…Elective repair of umbilical and inguinal hernias in the setting of cirrhosis seems to be advantageous in terms of morbidity and mortality when compared to emergent surgery. 3,14,15 For liver transplant candidates with inguinal hernias, options include elective surgery prior to liver transplantation (LT), simultaneous repair at the time of LT, or delayed repair after LT once the ascites has improved. 4,16 The risk of incarceration and the severity of symptoms might influence the decision-making.…”

Section: Introductionmentioning

confidence: 99%

“…Although inguinal hernia repair is considered an intervention of lower severity when compared to other more complex abdominal surgical procedures, the presence of one or more risk factors may negatively influence postoperative results and should be seriously considered. 3,15,22 Telem et al 22 observed that low preoperative albumin levels strongly correlated with poor surgical outcomes in patients with advanced cirrhosis and MELD scores ≥15. Moreover, Salamone et al identified emergency interventions, Child-Turcotte-Pugh (CTP) Class C, American Society of Anesthesiologists (ASA) physical status scores ≥3, and MELD scores ≥20 as independent risk factors by multivariate analysis for postoperative morbidity and mortality in adult cirrhotic patients undergoing incarcerated groin hernia repair.…”

Section: Introductionmentioning

confidence: 99%

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Inguinal Hernias in Cirrhotic Patients: From Diagnosis to Treatment

et al. 2021

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Cirrhosis has a strong association with abdominal wall hernias, especially in the presence of concomitant ascites. Major predisposing factors for hernia formation in this particular group of patients include increased intra-abdominal pressure and decreased muscle mass due to poor nutrition. Management of these patients is highly challenging and requires an experienced multidisciplinary surgical and medical approach. The aim of our review is to clarify crucial diagnostic and management approaches. Crucial medical and technical issues on this topic are widely discussed with special focus on indication, timing, and type of surgical repair, with an additional reference to the actual role of laparoscopy.

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Section: Introductionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Inguinal Hernias in Cirrhotic Patients: From Diagnosis to Treatment

et al. 2021

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“…Assim como citado anteriormente, pacientes com ascite apresentam maior incidência de hérnias da parede abdominal 63 . Foi constatado que existe associação entre AKI PO , grau de ascite e paracentese prévia, corroborando a presença de maior número de complicações nesses casos.…”

Section: Comparação Dos Grupos (Aki Po)unclassified

Avaliação da função renal no pós-operatório de herniorrafia de parede abdominal no paciente cirrótico

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Frailty Is a Risk Factor for Postoperative Mortality in Patients With Cirrhosis Undergoing Diverse Major Surgeries

et al. 2021

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Earn MOC for this article: www.wileyhealthlearning.com/aasld.aspx With a rising burden of cirrhosis surgeries, understanding risk factors for postoperative mortality is more salient than ever. The role of baseline frailty has not been assessed in this context. We evaluated the association between patient frailty and postoperative risk among diverse patients with cirrhosis and determined if frailty improves prognostication of cirrhosis surgical risk scores. This was a retrospective cohort study of U.S. veterans with cirrhosis identified between 2008 and 2016 who underwent nontransplant major surgery. Frailty was ascertained using the Hospital Frailty Risk Score (HFRS). Cox regression analysis was used to investigate the impact of patient frailty on postoperative mortality. Logistic regression was used to identify incremental changes in discrimination for postoperative mortality when frailty was added to the risk prediction models, including the Model for End-Stage Liver Disease (MELD), MELD-sodium (MELD-Na), Child-Turcotte-Pugh (CTP), Mayo Risk Score (MRS), and Veterans Outcomes and Costs Associated With Liver Disease (VOCAL)-Penn. A total of 804 cirrhosis surgeries were identified. The majority of patients (48.5%) had high-risk frailty at baseline (HFRS >15). In adjusted Cox regression models, categories of increasing frailty scores were associated with poorer postoperative survival. For example, intermediaterisk frailty (HFRS 5-15) conferred a 1.77-fold increased hazard relative to low-risk frailty (HFRS, <5; 95% confidence interval [CI], 1.06-2.95; P = 0.03). High-risk frailty demonstrated a similarly increased hazard (hazard ratio, 1.74; 95% CI, 1.05-2.88; P = 0.03), suggesting a threshold effect of frailty on postoperative mortality. The incorporation of frailty improved discrimination of MELD, MELD-Na, and CTP for postoperative mortality, but did not do so for the MRS or VOCAL-Penn score. Patient frailty was an additional important predictor of cirrhosis surgical risk. The incorporation of preoperative frailty assessments may help to risk stratify patients, especially in settings where the MELD-Na and CTP are commonly applied.

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The abdominal wall incisional hernia repair in cirrhotic patients

Cited by 11 publications

References 24 publications

Inguinal Hernias in Cirrhotic Patients: From Diagnosis to Treatment

Inguinal Hernias in Cirrhotic Patients: From Diagnosis to Treatment

Avaliação da função renal no pós-operatório de herniorrafia de parede abdominal no paciente cirrótico

Frailty Is a Risk Factor for Postoperative Mortality in Patients With Cirrhosis Undergoing Diverse Major Surgeries

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