Incisional hernia after liver transplantation: mesh-based repair and what else?

Surg Today. 2021 May;51(5):733-737. doi: 10.1007/s00595-020-02162-9. Epub 2020 Oct 16.

Abstract

Purpose: Incisional hernia (IH) is not uncommon after liver transplantation (LT). We investigated the long-term outcome of mesh-based hernia repair using an inlay-onlay technique.

Methods: Our analysis was based on a prospective collected database of all LT recipients from our hospital over a period of 15 years. We analyzed clinical data including the period between LT and hernia development, the size and localization of the hernia, the length of in-hospital stay, immunosuppression, and postoperative morbidity, as well as follow-up data. The median follow-up period was 120 (range 12-200) months.

Results: Among a total of 220 patients who underwent a collective 239 LTs, 29 (13%) were found to have an IH after a median period of 27.5 months (range 3-96 months). There were 12 (41%) men and 17 (59%) women, with a median age of 51 years. The median size of the IH was 13 cm (range 2-30 cm) and the median in-hospital stay was 6 days. Mild postoperative complications developed in seven patients, including two onlay mesh infections. One patient (3.4%) suffered recurrence.

Conclusion: Mesh-based hernia repair using the inlay/onlay technique represents an effective and safe method for patients with an IH after LT, without additional risk from continuous immunosuppression.

Keywords: Incisional hernia; Liver transplantation; Mesh.

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Herniorrhaphy / methods*
  • Humans
  • Immunosuppression Therapy / adverse effects
  • Incisional Hernia / epidemiology
  • Incisional Hernia / etiology
  • Incisional Hernia / surgery*
  • Length of Stay
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery*
  • Recurrence
  • Surgical Mesh*
  • Time Factors
  • Treatment Outcome
  • Young Adult