Management of inguinal herniae in patients on continuous ambulatory peritoneal dialysis: an audit of current UK practice.
Patients receiving continuous ambulatory peritoneal dialysis are at increased risk for the development of inguinal herniae, with a reported prevalence of 14%. Elective hernia repair is indicated for these patients as strangulation is associated with a high mortality in this population. There are currently no national guidelines relating to the optimal peri-operative management of these patients, in particular the appropriate pre- and post-operative dialysis regimen. The aim of the current study was to evaluate current practice in the UK by means of a postal questionnaire sent to all centres undertaking renal transplantation. Replies were received from 34/37 centres. The principal study finding was the wide variation in surgical practice between different centres with regard to pre- and post-operative dialysis regimes. Only 44% of centres had an established protocol. Based upon the study findings we have devised a protocol that we hope to see implemented into UK practice. Following its introduction, a re-assessment will be performed and the audit cycle completed.
Morris-Stiff
G J
GJ
Department of Transplant Surgery, University Hospital of Wales, Heath Park, Cardiff, UK.
Bowrey
D J
DJ
Jurewicz
W A
WA
Lord
R H
RH
D002985:Clinical Protocols; D019538:Health Care Surveys; D006552:Hernia, Inguinal / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008485:Medical Audit; D010346:Patient Care Management; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D006435:Renal Dialysis / Q000379:methods; D012307:Risk Factors; D011795:Surveys and Questionnaires; D006113:United Kingdom