Outcome analysis of laparoscopic incisional hernia repair and risk factors for hernia recurrence in liver transplant patients.
BACKGROUND
Incisional hernia is a common complication after liver transplantation (LT). Immunosuppression, obesity, and use of steroids are known risk factors. The purpose of the retrospective study was to summarize and evaluate experiences and results of laparoscopic intraperitoneal onlay mesh (IPOM) hernia repair.


METHODS
We reviewed our liver transplant patients over a seven-yr period with laparoscopic incisional hernia repair (LIHR) to direct our attention on risk factors for hernia recurrence after hernia repair.


RESULTS
Fifty-four patients after LT with incisional hernia were treated with laparoscopic repair, 42 male and 12 female patients of overall mean age of 58 ± 9 yr and body mass index (BMI) of 25 ± 4 kg/m(2) . A total of 755 LTs were performed at our institution in this time period, resulting in 7.15% of patients undergoing laparoscopic hernia repair. The mean postoperative hospital stay after was nine d. During the follow-up, nine recurrent hernias were noted (17%). BMI (p = 0.001) and sirolimus as immunosuppressive therapy were significantly associated with hernia recurrence (p = 0.014).


CONCLUSIONS
LIHR is a safe and feasible method to treat hernias after LT. BMI and sirolimus as immunosuppressive therapy are risk factors for recurrence of hernia after laparoscopic hernia repair.
Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria.
Sascha
S
Weiss
Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria.
Annemarie
A
Weissenbacher
Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria.|Department of General, Visceral and Transplantation Surgery, Charite Universitätsmedizin Berlin, Berlin, Germany.
Robert
R
Sucher
Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria.
Christian
C
Denecke
Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria.
Andreas
A
Brandl
Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria.
Franka
F
Messner
Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria.|Department of General, Visceral and Transplantation Surgery, Charite Universitätsmedizin Berlin, Berlin, Germany.
Robert
R
Oellinger
Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria.
Stefan
S
Schneeberger
Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria.
Thomas
T
Schmid
Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria.|Department of General, Visceral and Transplantation Surgery, Charite Universitätsmedizin Berlin, Berlin, Germany.
Johann
J
Pratschke
Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria.|Department of General, Visceral and Transplantation Surgery, Charite Universitätsmedizin Berlin, Berlin, Germany.
Matthias
M
Biebl
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D000069290:Incisional Hernia / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013526:Surgical Mesh; D016896:Treatment Outcome
hernia recurrence; incisional hernia; intraperitoneal onlay mesh; laparoscopic hernia repair; liver transplantation