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Laparoscopic repair of incisional hernia in solid organ-transplanted patients: The method of choice?
MedLine Citation:
PMID:  24684675     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Due to immunosuppressive (IS) therapy, incisional hernias are overrepresented in the organ-transplanted (Tx) population with larger defects, a high rate of recurrence and a tendency towards more seromas and infectious problems.
METHODS: 31 Tx/IS patients with a control group of 70 non-IS patients with incisional hernia (6/7 recurrences) were included in a prospective interventional study. Both cohorts were treated with laparoscopic ventral hernia repair (LVHR).
RESULTS: Follow-up time & rate was 37 months & 95%. 100 LVHR's were completed as there was one conversion in the Tx/IS group. No late infections or mesh removals occurred. Recurrence rates were 9.7% vs. 4.2% (p=0.37) and the overall complication rates were 19% vs. 27% (p=0.80). The Tx/IS group had a higher mesh-protrusion rate (29% vs. 13%, p=0.09), but also larger hernias. Polycystic kidney disease was overrepresented in the Tx cohort (44% of kidney-Tx).
CONCLUSION: Incisional hernias in Tx/IS patients may be treated by LVHR with the same low complication rate and recurrence rate as non-IS patients. By LVHR the highly problematic seroma/infection problems encountered in Tx/IS patients treated by conventional open technique seem almost eliminated. The minimally invasive procedure seems particularly rational in the Tx/Is population, and should be the method of choice. (ClinicalTrials.gov number: NCT00455299). This article is protected by copyright. All rights reserved.
Authors:
Jan Roland Lambrecht; Morten Skauby; Erik Trondsen; Arild Vaktskjold; Ole Morten Oyen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-3-31
Journal Detail:
Title:  Transplant international : official journal of the European Society for Organ Transplantation     Volume:  -     ISSN:  1432-2277     ISO Abbreviation:  Transpl. Int.     Publication Date:  2014 Mar 
Date Detail:
Created Date:  2014-4-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908516     Medline TA:  Transpl Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
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