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SINGLE‐CENTRE EXPERIENCE WITH MESH REPAIR OF ABDOMINAL HERNIA IN CAPD PATIENTS
Author(s) -
Johns E. M.,
Poole G.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04119_20.x
Subject(s) - medicine , surgery , laparotomy , peritonitis , continuous ambulatory peritoneal dialysis , hernia , peritoneal dialysis , hernia repair , incisional hernia , abdominal hernia
Purpose Patients with end stage renal failure on continuous ambulatory peritoneal dialysis (CAPD) represent a potentially infected environment in which to use mesh for the repair of abdominal hernia. We present a review of our experience with these patients. Methodology Retrospective review of all mesh repairs of abdominal hernia in CAPD patients performed by the senior author from 1997–2006. Results 46 patients had 54 hernias repaired (25 umbilical, 18 inguinal, 9 incisional and 2 epigastric) using polypropylene mesh. 13 patients had simultaneous Tenckhoff catheter insertion. Median age was 63 years (range 22–85) and 22 were diabetic. CAPD was commenced or recommenced a median of 2 weeks after the repair (range 0 days–6 weeks). 6 short‐term complications were recorded. 2 patients were treated for culture negative CAPD peritonitis within the first week after repair. 2 patients had localised wound bleeding and 1 patient was admitted with a wound infection. All were treated conservatively and no patient required mesh removal. 1 patient developed CAPD peritonitis at one month post‐operation and required Tenckhoff removal, subsequent laparotomy and conversion to haemodialysis. At a median follow‐up of 30 months (range 3–87) 29 patients were still alive and 2 patients were lost to follow‐up. There were 4 documented recurrences and 1 patient had been converted to haemodialysis because of hernia recurrence. Conclusions Mesh can be safely used to repair most hernias in CAPD patients. The results are comparable to those in healthy patients and mesh removal due to infection is extremely rare.