| Incisional hernia after liver transplantation. | |
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MedLine Citation:
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PMID: 17000384 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Incisional hernia is a potential complication of orthotopic liver transplantation (OLT), with various options for repair. STUDY DESIGN: We conducted a retrospective review of a series of adult patients with incisional hernias after OLT to identify risk factors and to compare methods of repair. RESULTS: Incisional hernia repair was performed in 44 of 959 patients (4.6%) who underwent OLT from 1999 to 2005. Mean age at time of OLT was 53 years, and 73% were men. One or more complications of OLT occurred in 33 patients (75%) and included reoperation for bile leak or hemoperitoneum (34%), pulmonary problems (27%), early acute rejection (7%), and severe ascites and retransplantation (5% each). Incisional hernia was diagnosed at 419 days (range 62 to 1,524 days) and repaired at 471 days (range 109 to 1,581 days) after OLT. Presentation included pain or discomfort (78%) and incarceration or strangulation (5%); 17% were asymptomatic. Herniorrhaphy techniques included fascial repair with onlay polypropylene mesh reinforcement (n=25, 57%); fascial repair only (n=15, 34%); or inlay mesh sewn to fascial edges (n=4, 9%). Complications of repair included recurrence in seven patients (16%) and wound infection and seroma in one patient each. Recurrence occurred in five patients with primary repair and two with mesh techniques (33% versus 6%, p=0.04). CONCLUSIONS: Incisional hernia is a late complication of OLT for which male gender and early post-OLT complications are risk factors. Repair is safe when undertaken after acute problems have resolved and is best accomplished using mesh reinforcement of autologous tissue. |
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Authors:
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Andrew J Vardanian; Douglas G Farmer; Rafik M Ghobrial; Ronald W Busuttil; Jonathan R Hiatt |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2006-08-17 |
Journal Detail:
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Title: Journal of the American College of Surgeons Volume: 203 ISSN: 1072-7515 ISO Abbreviation: J. Am. Coll. Surg. Publication Date: 2006 Oct |
Date Detail:
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Created Date: 2006-09-26 Completed Date: 2006-11-09 Revised Date: 2007-04-12 |
Medline Journal Info:
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Nlm Unique ID: 9431305 Medline TA: J Am Coll Surg Country: United States |
Other Details:
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Languages: eng Pagination: 421-5 Citation Subset: AIM; IM |
Affiliation:
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Division of Liver and Pancreas Transplantation, Department of Surgery, Dumont-UCLA Transplant Center, David Geffen School of Medicine at UCLA, 650 C.E. Young Drive South, Los Angeles, CA 90095, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Cohort Studies Female Hernia, Abdominal / diagnosis, etiology*, surgery* Humans Liver Transplantation / adverse effects* Male Middle Aged Retrospective Studies Risk Factors Suction Surgical Flaps* Suture Techniques* Sutures Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Liver Transpl. 2007 Feb;13(2):302-5
[PMID:
17256785
]
J Am Coll Surg. 2007 Mar;204(3):516; author reply 517 [PMID: 17324793 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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