title: Laparoscopic incisional hernia repair is feasible and safe after liver transplantation.
abstract: BACKGROUND
  Incisional hernia is a common complication after liver transplantation. The current study evaluated incidence and risk factors for incisional hernia and compared laparoscopic and open hernia repair in terms of feasibility and outcome.
  
  
  METHODS
  A cohort of 225 patients was prospectively investigated. The median follow-up period was 61 months (range, 6-186 months). The study cohort had 31 patients who underwent open repair and 13 who underwent laparoscopic repair.
  
  
  RESULTS
  Incisional hernia, found in 57 patients (25%), had occurred after a median of 17 months (range, 5-138 months). The significant risk factors were male gender (p = 0.001) and body mass index (BMI) greater than 25 kg/m(2) (p = 0.002). A trend toward a lower recurrence rate (15% vs 35%; p = 0.28) and fewer surgical complications (15% vs 19%; p = 0.99) was found in the laparoscopic group.
  
  
  CONCLUSIONS
  Incisional hernia is a frequent complication after liver transplantation. Associated risk factors are male gender and a BMI greater than 25 kg/m(2). Laparoscopic hernia repair for such patients is feasible and safe.
authors.affiliation: Department of Visceral Surgery and Medicine, Inselspital University Hospital Bern and University Bern, CH-3010 Bern, Switzerland.
authors.forename: Anita
authors.initials: A
authors.lastname: Kurmann
authors.forename: Guido
authors.initials: G
authors.lastname: Beldi
authors.forename: Stephan A
authors.initials: SA
authors.lastname: Vorburger
authors.forename: Christian A
authors.initials: CA
authors.lastname: Seiler
authors.forename: Daniel
authors.initials: D
authors.lastname: Candinas
mesh_terms: D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D012307:Risk Factors; D012737:Sex Factors; D013536:Suture Techniques; D013557:Switzerland / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome