[Current trends in the treatment of incisional hernia in patients after kidney transplantation].
The incidence of incisional hernia following abdominal surgery varies between 2 and 13%, the rate of incisional hernia after renal transplantation varies between 1.1 and 3.8%. There are no evidence based guidelines regarding the treatment of incisional hernias in renal transplant recipients. The aim of this study was to compare results of surgical repair of incisional hernia in patients after renal transplantation depending on the treatment method. A Pubmed was searched for articles related to the treatment of patients with incisional hernia after renal transplantation. Finally five articles were used for review. The analyzed papers report a total of 5606 patients in a time period between 1965-2004. Hernia mesh repairs were similar - primary approximation of the fascial borders and polypropylene mesh reinforcement, mainly by on lay technique or by suturing the mesh to fascial edges. Hernia repairs without mesh were diverse: simple closure, component separation technique, tensor fascia late grafts, split thickness skin grafting. Although all authors are concerned about prosthetic mesh use for hernia repair in transplant patients, four of them advise this method. Surprisingly, the incidence of incisional hernia in transplant recipients (1.83%) is no higher than in normal population (2-13%). Hernia recurrence in the analyzed group was 2% for prosthetic mesh repair, and 25% for no mesh repair. Prosthetic mesh repair of incisional hernias after kidney transplantation is a safe technique and starting to displace other methods of treatment.
Kieszek
Rafał
R
Warszawski Uniwersytet Medyczny, Klinika Chirurgii Ogólnej i Transplantacyjnej. rafal.kieszek@gmail.com
Wszola
Michał
M
Domagała
Piotr
P
Chmura
Andrzej
A
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D046449:Hernia, Abdominal / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D012307:Risk Factors; D013526:Surgical Mesh; D013536:Suture Techniques
D000900:Anti-Bacterial Agents