Abdominal wall hernias in end-stage renal disease patients on peritoneal dialysis.
OBJECTIVE
To describe our experience with hernioplasty in peritoneal dialysis patients and to identify possible risk factors for surgical complications.


METHODS
A 4-year retrospective chart review of data.


METHODS
Peritoneal dialysis unit of a university hospital.


METHODS
58 hernias in 50 patients were included. Detailed surgical technique and complications were recorded. Possible risk factors included age, gender, weight, height, body mass index, previous surgery, diabetes, time on dialysis, emergency surgery, hospital stay, type of hernia, mesh use, blood hemoglobin, and serum urea, creatinine, and potassium.


RESULTS
Complications occurred in 12 hernioplasties (4 wound infections, 2 peritonitis, 4 catheter dysfunction, and 5 re-operations). Recurrence rate was 12% without mesh use and 0% with mesh hernioplasty. Dialysis was re-instituted in 96% of cases within 3 days postoperatively. Identified risk factors for complications were diabetes, low weight, low height, small body mass index, and low serum creatinine.


CONCLUSIONS
Mesh hernioplasty in peritoneal dialysis patients is advisable. Postoperative dialysis with low volume is feasible after surgery. Prospective studies will corroborate our risk factors for morbidity.
Department of Surgery, IMSS Adolfo Ruiz Cortines National Medical Center, Veracruz, Mexico. gmtzmier@hotmail.com
Gustavo
G
Martínez-Mier
Eduardo
E
Garcia-Almazan
Hugo E
HE
Reyes-Devesa
Victor
V
Garcia-Garcia
Sergio
S
Cano-Gutierrez
Reymundo
R
Mora Y Fermin
Jorge
J
Estrada-Oros
Luis F
LF
Budar-Fernandez
Sandro F
SF
Avila-Pardo
Gustavo F
GF
Mendez-Machado
D000293:Adolescent; D000328:Adult; D000368:Aged; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D046449:Hernia, Abdominal / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013526:Surgical Mesh / Q000009:adverse effects; D016896:Treatment Outcome