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Published on: March 10, 2023
Umbilical hernia management during liver transplantation
B de Goede1, B J H van Kempen, W G Polak
1Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. b.degoede@erasmusmc.nl
Summary
For liver transplant patients with umbilical hernias, separate incision repair is better. This method significantly reduces hernia recurrence compared to using the same incision for both procedures.
Area of Science:
- Hepatology
- Surgical Oncology
- Gastroenterology
Background:
- Liver cirrhosis patients often have concurrent umbilical hernias.
- Management strategies for combined liver transplantation and umbilical hernia repair are not well-defined.
Purpose of the Study:
- To compare outcomes of umbilical hernia repair during liver transplantation using a separate infra-umbilical incision versus the same incision.
Main Methods:
- Retrospective review of 27 patients (1990-2011) undergoing liver transplantation with umbilical hernia repair.
- Group 1: Separate infra-umbilical incision (n=17).
- Group 2: Same incision (n=10).
Main Results:
- Lower recurrence rate in the separate incision group (6%) vs. same incision group (40%, p=0.047).
- One patient in the same incision group required emergency surgery for bowel incarceration.
- Recurrent hernias were successfully managed, with elective repair in the separate incision group.
Conclusions:
- Separate infra-umbilical incision for umbilical hernia repair during liver transplantation is associated with better outcomes.
- This approach minimizes the risk of recurrence and associated complications.
