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Perit Dial Int 28(4): 391-396
2008
© 2008 International Society for Peritoneal Dialysis
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ORIGINAL ARTICLES

ABDOMINAL WALL HERNIAS IN END-STAGE RENAL DISEASE PATIENTS ON PERITONEAL DIALYSIS

Gustavo Martínez-Mier1,2, Eduardo Garcia-Almazan1, Hugo E. Reyes-Devesa1, Victor Garcia-Garcia3, Sergio Cano-Gutierrez3, Reymundo Mora y Fermin3, Jorge Estrada-Oros3, Luis F. Budar-Fernandez3, Sandro F. Avila-Pardo3 and Gustavo F. Mendez-Machado4

Department of Surgery,1 IMSS Adolfo Ruiz Cortines National Medical Center; Department of Research,2 School of Medicine, Universidad Cristobal Colon; Department of Nephrology3 and Department of Research,4 IMSS Adolfo Ruiz Cortines National Medical Center, Veracruz, Mexico

Correspondence to: G. Martínez-Mier, Primero de Mayo 1612-206, Flores Magón, Veracruz, Veracruz, 91900 Mexico. gmtzmier{at}hotmail.com

{diamondsuit} Objective: To describe our experience with hernioplasty in peritoneal dialysis patients and to identify possible risk factors for surgical complications.

{diamondsuit} Design: A 4-year retrospective chart review of data.

{diamondsuit} Setting: Peritoneal dialysis unit of a university hospital.

{diamondsuit} Patients and Methods: 58 hernias in 50 patients were included. Detailed surgical technique and complications were recorded. Possible risk factors included age, gender, weight, height, body mass index, previous surgery, diabetes, time on dialysis, emergency surgery, hospital stay, type of hernia, mesh use, blood hemoglobin, and serum urea, creatinine, and potassium.

{diamondsuit} Results: Complications occurred in 12 hernioplasties (4 wound infections, 2 peritonitis, 4 catheter dysfunction, and 5 re-operations). Recurrence rate was 12% without mesh use and 0% with mesh hernioplasty. Dialysis was re-instituted in 96% of cases within 3 days postoperatively. Identified risk factors for complications were diabetes, low weight, low height, small body mass index, and low serum creatinine.

{diamondsuit} Conclusions: Mesh hernioplasty in peritoneal dialysis patients is advisable. Postoperative dialysis with low volume is feasible after surgery. Prospective studies will corroborate our risk factors for morbidity.

KEY WORDS: Abdominal wall hernia.

Received 16 July 2007; accepted 18 January 2008.






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