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Erschienen in: Hernia 1/2019

08.11.2018 | Original Article

Predictors of incisional hernia in adult liver transplant recipients

verfasst von: J. S. Lee, J. M. Kim, K. S. Kim, G.-S. Choi, J.-W. Joh, S.-K. Lee

Erschienen in: Hernia | Ausgabe 1/2019

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Abstract

Purpose

Incisional hernia is a complication following abdominal operation. Patients undergoing liver transplantation have a high risk of developing incisional hernia because of immunosuppression. The purpose of this study was to evaluate incisional hernia after liver transplantation and to identify risk factors for hernia formation in those patients.

Methods

We retrospectively reviewed 1044 adult patients with more than 2 years of follow-up in patients who underwent liver transplantation from January 2000 to December 2015.

Results

Incisional hernia was identified in 79 patients with more than 2 years of follow-up. The overall incisional hernia rate was 7.6%. The mean age and body mass index (BMI) of the patients with incisional hernia were 55 ± 9 years and 25.3 ± 3.7 kg/m2, respectively. No significant differences in gender, diagnosis, diabetes, Child–Pugh score, model for end-stage liver disease (MELD) score, donor type, hepatorenal syndrome, varix bleeding, ascites, hepatic encephalopathy, ventilator use, spontaneous bacterial peritonitis (SBP), or bile leakage were found between patients who did and did not develop incisional hernia. Patients with acute rejection before hernia development were more to have herniated patients hernia (p < 0.05).

Conclusion

Age greater than 55 years and high BMI were significant risk factors. We identified risk factors for the development of incisional hernia. Based on these risk factors, attention should be paid to incisional hernia in older and obese patients.
Literatur
1.
Zurück zum Zitat Bucknall TE, Cox PJ, Ellis H (1982) Burst abdomen and incisional hernia: a prospective study of 1129 major laparotomies. Br Med J Clin Res Ed 284:931–933CrossRefPubMedCentralPubMed Bucknall TE, Cox PJ, Ellis H (1982) Burst abdomen and incisional hernia: a prospective study of 1129 major laparotomies. Br Med J Clin Res Ed 284:931–933CrossRefPubMedCentralPubMed
2.
Zurück zum Zitat Israelsson LA, Jonsson T (1996) Incisional hernia after midline laparotomy: a prospective study. Eur J Surg 162:125–129PubMed Israelsson LA, Jonsson T (1996) Incisional hernia after midline laparotomy: a prospective study. Eur J Surg 162:125–129PubMed
3.
Zurück zum Zitat Mudge M, Hughes LE (1985) Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg 72:70–71CrossRef Mudge M, Hughes LE (1985) Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg 72:70–71CrossRef
4.
Zurück zum Zitat Bachir NM, Larson AM (2012) Adult liver transplantation in the United States. Am J Med Sci 343:462–469CrossRefPubMed Bachir NM, Larson AM (2012) Adult liver transplantation in the United States. Am J Med Sci 343:462–469CrossRefPubMed
5.
Zurück zum Zitat Kahn J, Muller H, Iberer F, Kniepeiss D, Duller D, Rehak P, Tscheliessnigg K (2007) Incisional hernia following liver transplantation: incidence and predisposing factors. Clin Transpl 21:423–426CrossRef Kahn J, Muller H, Iberer F, Kniepeiss D, Duller D, Rehak P, Tscheliessnigg K (2007) Incisional hernia following liver transplantation: incidence and predisposing factors. Clin Transpl 21:423–426CrossRef
6.
Zurück zum Zitat Piazzese E, Montalti R, Beltempo P, Bertelli R, Puviani L, Pacile V, Nardo B, Cavallari A (2004) Incidence, predisposing factors, and results of surgical treatment of incisional hernia after orthotopic liver transplantation. Transpl Proc 36:3097–3098CrossRef Piazzese E, Montalti R, Beltempo P, Bertelli R, Puviani L, Pacile V, Nardo B, Cavallari A (2004) Incidence, predisposing factors, and results of surgical treatment of incisional hernia after orthotopic liver transplantation. Transpl Proc 36:3097–3098CrossRef
7.
Zurück zum Zitat Vardanian AJ, Farmer DG, Ghobrial RM, Busuttil RW, Hiatt JR (2006) Incisional hernia after liver transplantation. J Am Coll Surg 203:421–425CrossRefPubMed Vardanian AJ, Farmer DG, Ghobrial RM, Busuttil RW, Hiatt JR (2006) Incisional hernia after liver transplantation. J Am Coll Surg 203:421–425CrossRefPubMed
8.
Zurück zum Zitat Lam HD, Vanlander A, Berrevoet F (2016) A comparative outcome analysis of incisional hernia repair in patients who underwent liver transplantation vs. those that underwent hepatopancreaticobiliary surgery using the EHS guidelines as a means of comparison. Clin Transpl 30:226–232CrossRef Lam HD, Vanlander A, Berrevoet F (2016) A comparative outcome analysis of incisional hernia repair in patients who underwent liver transplantation vs. those that underwent hepatopancreaticobiliary surgery using the EHS guidelines as a means of comparison. Clin Transpl 30:226–232CrossRef
9.
Zurück zum Zitat Smith CT, Katz MG, Foley D, Welch B, Leverson GE, Funk LM, Greenberg JA (2015) Incidence and risk factors of incisional hernia formation following abdominal organ transplantation. Surg Endosc 29:398–404CrossRefPubMed Smith CT, Katz MG, Foley D, Welch B, Leverson GE, Funk LM, Greenberg JA (2015) Incidence and risk factors of incisional hernia formation following abdominal organ transplantation. Surg Endosc 29:398–404CrossRefPubMed
10.
Zurück zum Zitat Gomez R, Hidalgo M, Marques E, Marin L, Loinaz C, Gonzalez I, Garcia I, Moreno E (2001) Incidence and predisposing factors for incisional hernia in patients with liver transplantation. Hernia 5:172–176CrossRefPubMed Gomez R, Hidalgo M, Marques E, Marin L, Loinaz C, Gonzalez I, Garcia I, Moreno E (2001) Incidence and predisposing factors for incisional hernia in patients with liver transplantation. Hernia 5:172–176CrossRefPubMed
11.
Zurück zum Zitat Kim JM, Kwon CH, Joh JW, Ha YE, Sinn DH, Choi GS, Peck KR, Lee SK (2015) Oral Valganciclovir as a preemptive treatment for cytomegalovirus (CMV) infection in CMV-seropositive liver transplant recipients. PLoS One 10:e0123554CrossRefPubMedCentralPubMed Kim JM, Kwon CH, Joh JW, Ha YE, Sinn DH, Choi GS, Peck KR, Lee SK (2015) Oral Valganciclovir as a preemptive treatment for cytomegalovirus (CMV) infection in CMV-seropositive liver transplant recipients. PLoS One 10:e0123554CrossRefPubMedCentralPubMed
12.
Zurück zum Zitat Janssen H, Lange R, Erhard J, Malago M, Eigler FW, Broelsch CE (2002) Causative factors, surgical treatment and outcome of incisional hernia after liver transplantation. Br J Surg 89:1049–1054CrossRef Janssen H, Lange R, Erhard J, Malago M, Eigler FW, Broelsch CE (2002) Causative factors, surgical treatment and outcome of incisional hernia after liver transplantation. Br J Surg 89:1049–1054CrossRef
13.
Zurück zum Zitat Shi LW, Verran D, Rao AR, Stewart GJ, Mccaughan GW (2003) Incisional hernia following orthotopic liver transplantation. Transpl Proc 35:425–426CrossRef Shi LW, Verran D, Rao AR, Stewart GJ, Mccaughan GW (2003) Incisional hernia following orthotopic liver transplantation. Transpl Proc 35:425–426CrossRef
14.
Zurück zum Zitat Caglia P, Tracia A, Borzi L, Amodeo L, Tracia L, Veroux M, Amodeo C (2014) Incisional hernia in the elderly: risk factors and clinical considerations. Int J Surg 12(Suppl 2):S164–S169CrossRefPubMed Caglia P, Tracia A, Borzi L, Amodeo L, Tracia L, Veroux M, Amodeo C (2014) Incisional hernia in the elderly: risk factors and clinical considerations. Int J Surg 12(Suppl 2):S164–S169CrossRefPubMed
15.
Zurück zum Zitat Risk Factor NCD Collaboration (2016) Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet 387:1377–1396CrossRef Risk Factor NCD Collaboration (2016) Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet 387:1377–1396CrossRef
16.
Zurück zum Zitat Sauerland S, Korenkov M, Kleinen T, Arndt M, Paul A (2004) Obesity is a risk factor for recurrence after incisional hernia repair. Hernia 8:42–46CrossRefPubMed Sauerland S, Korenkov M, Kleinen T, Arndt M, Paul A (2004) Obesity is a risk factor for recurrence after incisional hernia repair. Hernia 8:42–46CrossRefPubMed
17.
Zurück zum Zitat Sugerman HJ, Kellum JM Jr, Reines HD, Demaria EJ, Newsome HH, Lowry JW (1996) Greater risk of incisional hernia with morbidly obese than steroid-dependent patients and low recurrence with prefascial polypropylene mesh. Am J Surg 171:80–84CrossRefPubMed Sugerman HJ, Kellum JM Jr, Reines HD, Demaria EJ, Newsome HH, Lowry JW (1996) Greater risk of incisional hernia with morbidly obese than steroid-dependent patients and low recurrence with prefascial polypropylene mesh. Am J Surg 171:80–84CrossRefPubMed
Metadaten
Titel
Predictors of incisional hernia in adult liver transplant recipients
verfasst von
J. S. Lee
J. M. Kim
K. S. Kim
G.-S. Choi
J.-W. Joh
S.-K. Lee
Publikationsdatum
08.11.2018
Verlag
Springer Paris
Erschienen in
Hernia / Ausgabe 1/2019
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-018-1845-6

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