Continuing CAPD after herniotomy.
There is still controversy as to whether PD-treatment can be safely continued after herniotomy (HT). Many nephrologists withhold PD-treatment for several weeks after HT in fear of dialysate leakage and/or hernia recurrence. We report on 12 patients (2 women, 10 men) in whom HT was performed either for umbilical (n = 6), inguinal (n = 6) or open processus vaginalis (n = 3). Surgery was performed according to the Lichtenstein method with insertion of a Marlex-mesh and ligation of the hernia sac. In all patients PD treatment was paused for the day of surgery and 1 to 3 days postoperatively, depending on RRF. Low volume (1.0 to 1.5 l) and high frequency exchanges (6 exchanges per day) were started for several days with a gradual reinstitution of the former PD-regimen within the next 2 to 4 weeks. All patients did well rapidly with no uraemia-or dialysis-related complications. No leakage and no hernia recurrence could be observed 3 months thereafter. None of the patients had to be haemodialysed intercurrently. In conclusion, continuing a modified regimen of PD-treatment after HT seems to be safe and comfortable for the patient.
Tast
C
C
Robert-Bosch-Hospital, Department of Internal Medicine, Division of General Internal Medicine and Nephrology, Stuttgart, Germany. c.tast@t-online.de
Kuhlmann
U
U
Stölzing
H
H
Alscher
D
D
Mettang
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000209:etiology* / Q000601:surgery*; D006554:Hernia, Umbilical / Q000209:etiology* / Q000601:surgery*; D006555:Hernia, Ventral / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008026:Ligation; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects* / Q000379:methods*; D011182:Postoperative Care / Q000379:methods*; D013526:Surgical Mesh; D013997:Time Factors; D016896:Treatment Outcome