Surgical treatment of ventral hernia with liver cirrhosis or after liver transplantation: a report of 35 cases
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R656.2

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    Abstract:

    Objective: To investigate the clinical efficacy of ventral hernia repair for patients with liver cirrhosis or after liver transplantation. Methods: The clinical data of 35 ventral hernia patients with liver cirrhosis or after liver transplantation undergoing elective hernia repair in the First Affiliated Hospital of Sun Yat-Sen University from January 2006 to December 2016 were analyzed retrospectively. Of the patients, 18 cases were inguinal hernia, 10 cases were ventral incisional hernia, 5 cases were umbilical hernia, one case had concomitant umbilical hernia and incisional hernia and one case had hernia of the abdominal linea alba. The incidence of complications and recurrence of hernia after herniorrhaphy as well as the relevant clinical variables of the patients were analyzed. Results: Of the 35 patients, 27 cases were males and 8 cases were females, with an average age of (59.0±9.42) years; 16 cases (45.7%) had prolonged prothrombin time, 16 cases (45.7%) had hypoproteinemia, and 24 cases (68.5%) had ascites. the preoperative Child-Pugh classification was regarded as grade A in 16 cases of (45.7%) grade B in 18 cases (51.4%), and grade C in one case (2.8%); the preoperative ASA classification was defined as grade II in 11 cases (31.4%), grade III in 20 cases (57.1%), and grade IV in 4 cases (11.4%). Operation was successfully completed in all patients, and no perioperative death occurred. The average operative time and intraoperative blood loss were (97.0±18.7) min and (30.0±5.0) mL for inguinal hernia, (125±33.5) min and (100.5±23.5) mL for incisional hernia, and were (106.0±45.1) min and (40.5±20.5) mL for umbilical hernia, respectively. The median length of postoperative hospital stay was 8 (1–63) d. The overall incidence of postoperative complications was 22.8%, which included seroma in 2 cases (5.7%), hematoma in 4 cases (11.4%), wound infection in one case (2.9%), and surgical site infection in 2 cases (5.7%). The follow-up rate was 65.7% (23/35) and the median follow-up time was 25 months. Discomfort in the surgical region was reported in 2 cases (8.7%) and chronic pain was not reported in any of them. Recurrence occurred in 4 cases (17.4%), which included inguinal hernia and incisional hernia with 2 cases (8.7%) each. Conclusion: Elective herniorrhaphy for ventral hernia complicated with liver cirrhosis or after liver transplantation is safe and effective, but the incidence of postoperative complications and recurrence rate are relatively high.

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CHEN Songyao, DAI Weigang, CHEN Chuangqi, TAN Jinfu, ZUO Jidong, ZHAO Qiongyun, TAN Min. Surgical treatment of ventral hernia with liver cirrhosis or after liver transplantation: a report of 35 cases[J]. Chin J Gen Surg,2018,27(10):1266-1272.
DOI:10.7659/j. issn.1005-6947.2018.10.008

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History
  • Received:May 20,2018
  • Revised:September 19,2018
  • Adopted:
  • Online: October 25,2018
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