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Prosthetic mesh repair of multiple recurrent and large abdominal hernias in continuous ambulatory peritoneal dialysis
G Imvrios1, D Tsakiris, D Gakis
1Organ Transplantation Unit, University of Thessaloniki, Hippokration General Hospital, Greece.
Objective:
The aim of this study was to find out whether prosthetic mesh repair of recurrent and large abdominal hernias in continuous ambulatory peritoneal dialysis (CAPD) patients is effective in maintaining them on CAPD.
Design:
Retrospective analysis of case notes over a period of 5 years.
Setting:
Single renal unit of a university hospital.
Patients:
Forty-six of 217 CAPD patients (16%) had their hernias repaired. Among them, 5 women in whom hemodialysis was not possible had multiple or large hernias repaired with polypropylene (PP) mesh.
Results:
Radical repair was achieved by a modified operation consisting of a conventional hernioplasty complemented by a supporting prostetic overlay mesh, without discontinuation of CAPD. The patients continued CAPD for a mean period of 17.6 months without hernia recurrence. Two patients died in the twelfth and fifteenth post-operative month due to cardiac arrest and hepatic failure, respectively, and the remaining 3 are alive and have been doing well on CAPD for 13, 14, and 21 months.
Conclusions:
Prosthetic mesh repair of large recurrent hernias in CAPD patients with vascular access problems seems to be a valuable method to maintain them on this renal replacement therapy.