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Anterior tension-free repair under local anesthesia of abdominal wall hernias in continuous ambulatory peritoneal dialysis patients

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Abstract

Background

A 10-year experience of abdominal wall hernia repair performed with anterior tension-free mesh or plug technique under local anesthesia in end-stage renal failure patients submitted to continuous ambulatory peritoneal dialysis (CAPD) is described in order to assess the safety and effectiveness of this approach.

Methods

Between January 1993 and December 2002, 18 hernia repairs were performed under local anesthesia in 16 patients (14 males and two females) with a mean age of 70 years (48–78). One umbilical and three unilateral inguinal hernias were observed and repaired before starting peritoneal dialysis (PD), while two umbilical, eight unilateral, and two bilateral groin hernias developed and were then treated during PD. Repairs were performed electively in all but one case, which was an emergency operation for strangulation. An ipsilateral scrotal swelling was also present in two indirect unilateral inguinal hernias. In these cases, the hernia sac was ligated before entering, while in the others it was simply dissected and inverted.

Results

Patients were discharged the same day or the day after surgery. No local or general immediate or late complications occurred. CAPD in subjects operated on during PD treatment was resumed the same day of surgery. In no instance was hernia recurrence or leak of dialysis solution observed at follow-up examinations.

Conclusions

The absence of surgical and general complications and the nearly immediate resumption of PD indicate the anterior tension-free repair under local anesthesia as a safe and effective technique for CAPD patients even in an ambulatory or day-surgery setting.

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References

  1. Mehrota R, Nolph KD (2000) Current status of peritoneal dialysis. In: Gokal R, Khanna R, Krediet RTh, Noplph KD (eds) Textbook of Peritoneal Dialysis. Kluwer, London, pp 19–35

  2. Afthentopoulos IE, Panduranga Rao S, Mathews R, Oreopoulos DG (1998) Hernia development in CAPD patients and the effect of 2,5 l dialysate volume in selected patients. Clin Nephrol 49: 251-257

    CAS  PubMed  Google Scholar 

  3. Pauls DG, Basinger BB, Shield CF (1992) Inguinal herniorrhaphy in the continuous ambulatory peritoneal dialysis patient. Am J Kidney Dis 20: 497–9

    CAS  PubMed  Google Scholar 

  4. Ralph-Edwards A, Maziak D, Deitel M (1994) Sudden rupture of an indirect inguinal hernial sac with extravasation in two patients on continuous ambulatory peritoneal dialysis. Can J Surg 37: 70-73

    CAS  PubMed  Google Scholar 

  5. Abraham GA, Blake PG, Mathews RE, Bargman JM, Izatt S, Oreopoulos DG (1990) Genital swelling as a surgical complication of continuous ambulatory peritoneal dialysis. Surg Gynecol Obstet 170: 306-308

    CAS  PubMed  Google Scholar 

  6. Kopecky RT, Funk MM, Kreitzer PR (1985) Localized genital edema in patients undergoing continuous ambulatory peritoneal dialysis. J Urol 134: 880-884

    CAS  PubMed  Google Scholar 

  7. Singal K, Segel DP, Bruns FJ, Fraley DS, Adler S, Julian TB (1986) Genital edema in patients on continuous ambulatory peritoneal dialysis. Am J Nephrol 6: 471-475

    CAS  PubMed  Google Scholar 

  8. O’Connor JP, Rigby RJ, Hardie IR, Wall DR, Strong RW, Woodruff PW, Petrie JJ (1986) Abdominal hernias complicating continuous ambulatory peritoneal dialysis. Am J Nephrol 6: 271-274

    CAS  PubMed  Google Scholar 

  9. Rubin J, Raju S, Teal N, Hellems E, Bower JD (1982) Abdominal hernia in patients undergoing continuous ambulatory peritoneal dialysis. Arch Intern Med 142: 1453-1455

    Article  CAS  PubMed  Google Scholar 

  10. Twardowski ZJ, Khanna R (1989) Swan neck peritoneal dialysis catheter. In: Andreucci VE (ed) Vascular and peritoneal accesses for dialysis. Kluwer, Boston, pp 271-289

  11. Amid PK, Lichtenstein IL (1998) Long-term results and current status of the Lichtenstein open tension-free hernioplasty. Hernia 2:89–94

    Google Scholar 

  12. Spier N, Berliner SD (1998) The open tension-free mesh repair of inguinal hernia: Analysis of 1,235 cases. Hernia 2:81–83

    Google Scholar 

  13. Hernandez-Granados P, Ontanon M, Lasala M, Garcia C, Arguello M, Medina I (2000) Tension-free hernioplasty in primary inguinal hernia: A series of 2,054 cases. Hernia 4:141–143

    Google Scholar 

  14. Shulman AG, Amid PK, Lichtenstein IL (1990) The plug repair of 1402 recurrent inguinal hernias. Arch Surg 125: 265-257

    CAS  PubMed  Google Scholar 

  15. Bistrup C, Holm-Nielsen A, Pedersen RS (1996) Technique, survival and complication rates in a newly started CAPD centre (five years of experience). Perit Dial Int 16: 90-91

    CAS  PubMed  Google Scholar 

  16. Perez RA, Blake PG, **dal KA, Badovinac K, Trpeski L, Fenton SS; Canadian Organ Replacement Register-EPREX Study Group (2003) Changes in peritoneal dialysis practices in Canada 1996–1999. Perit Dial Int 23: 53-57

    PubMed  Google Scholar 

  17. Del Peso G, Bajo MA, Costero O, Hevia C, Gil F, Diaz C, Aguilera A, Selgas R (2003) Risk factors for abdominal wall complications in peritoneal dialysis patients. Perit Dial Int 23: 249-254

    PubMed  Google Scholar 

  18. Canivet E, Lavaud S, Wampach H, Wuillai A, Randoux C, Liehn JC, Chanard J (2000) Detection of subclinical abdominal hernia by peritoneal scintigraphy. Adv Perit Dial 16:104–107

    CAS  PubMed  Google Scholar 

  19. Bargmann JM (1986) Complications of peritoneal dialysis related to increased intra-abdominal pressure. Kidney Int 40 (suppl): 75–80

    Google Scholar 

  20. Kauffman HM Jr, Adams MB (1986) Indirect inguinal hernia in patients undergoing peritoneal dialysis. Surgery 99: 254-256

    PubMed  Google Scholar 

  21. Brittenden J, Heys SD, Eremin O (1991) Femoral hernia: mortality and morbidity following elective and emergency surgery. J R Coll Surg Edinb 36: 86-88

    CAS  PubMed  Google Scholar 

  22. Moffat EL, Deitel M, Thompson DA (1982) Abdominal surgery in patients undergoing long-term peritoneal dialysis. Surgery 92: 598–604

    CAS  PubMed  Google Scholar 

  23. Scanziani R, Dozio B, Caimi F, De Rossi N, Magri F, Surian M (1992) Peritoneography and peritoneal computerized tomography: a new approach to non-infectious complications of CAPD. Nephrol Dial Transplant 7: 1035-1038

    CAS  PubMed  Google Scholar 

  24. Capelluto CC, DeWolf WC (1993) Genital swelling secondary to leakage from continuous ambulatory peritoneal dialysis: computerized tomography diagnosis. J Urol 150: 196-198

    PubMed  Google Scholar 

  25. Gianetta E, De Cian F, Cuneo S, Friedman D, Vitale B, Marinari G, Banchieri G, Camerini G (1997) Hernia repair in elderly patients. Br J Surg 84: 983-985

    CAS  PubMed  Google Scholar 

  26. Lewis DM, Bingham C, Beaman M, Nicholls AJ, Riad HN (1998) Polypropylene mesh hernia repair—an alternetive permitting rapid return to peritoneal dialysis. Nephrol Dial Transplant 13: 2488-2489

    Article  CAS  PubMed  Google Scholar 

  27. Guzmna-Valdivia G, Zaga I (2001) Abdominal wall hernia repair in patients with chronic renal failure and a dialysis catheter. Hernia 5:9-11

    CAS  PubMed  Google Scholar 

  28. Marckmann P (1988) Nutritional status of patients on hemodialysis and peritoneal dialysis. Clin Nephrol 28: 75-78

    Google Scholar 

  29. Mattern WD, Hak LJ, Lamanna RW, Teasley KM, Laffell MS (1982) Malnutrition altered immune function and the risk of infection in maintenance hemodialysis patients. Am J Kidney Dis 1: 206-218

    CAS  PubMed  Google Scholar 

  30. Morris-Stiff GJ, Bowrey DJ, Jurewicz WA, Lord RH (1998) Management of inguinal herniae in patients on continuous ambulatory peritoneal dialysis: an audit of current UK practice. Postgrad Med J 74: 669-670

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery DICMI School of Medicine, University of Genova, Largo Rosanna Benzi 8, I-16132 , Genova, Italy

    E. Gianetta, D. Civalleri, A. Serventi, F. Floris & F. Mariani

  2. Department of Internal Medicine DIMI Division of Nephrology School of Medicine, University of Genova, Viale Benedetto XV 6, I-16132, Genova, Italy

    F. Aloisi & S. Saffioti

Authors
  1. E. Gianetta
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  2. D. Civalleri
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  3. A. Serventi
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  4. F. Floris
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  5. F. Mariani
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  6. F. Aloisi
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  7. S. Saffioti
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Correspondence to E. Gianetta.

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Gianetta, E., Civalleri, D., Serventi, A. et al. Anterior tension-free repair under local anesthesia of abdominal wall hernias in continuous ambulatory peritoneal dialysis patients. Hernia 8, 354–357 (2004). https://doi.org/10.1007/s10029-004-0251-4

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  • DOI: https://doi.org/10.1007/s10029-004-0251-4

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