Author/Authors :
Perez, A. J. Comprehensive Hernia Center- Digestive Disease and Surgery Institute- The Cleveland Clinic Foundation, Cleveland, OH, USA , Haskins, I. N. Comprehensive Hernia Center- Digestive Disease and Surgery Institute- The Cleveland Clinic Foundation, Cleveland, OH, USA , Prabhu, A. S. Comprehensive Hernia Center- Digestive Disease and Surgery Institute- The Cleveland Clinic Foundation, Cleveland, OH, USA , Krpata, D. M. Comprehensive Hernia Center- Digestive Disease and Surgery Institute- The Cleveland Clinic Foundation, Cleveland, OH, USA , Tu, C. Department of Quantitative Health Sciences- Lerner Research Institute-The Cleveland Clinic Foundation, Cleveland, OH, USA , Rosenblatt, S. Comprehensive Hernia Center- Digestive Disease and Surgery Institute- The Cleveland Clinic Foundation, Cleveland, OH, USA , Hashimoto, K. Transplantation Center- Digestive Disease and Surgery Institute-The Cleveland Clinic Foundation, Cleveland, OH, USA , Diago, T. Transplantation Center- Digestive Disease and Surgery Institute-The Cleveland Clinic Foundation, Cleveland, OH, USA , Eghtesad, B. Transplantation Center- Digestive Disease and Surgery Institute-The Cleveland Clinic Foundation, Cleveland, OH, USA , Rosen, M. l. J. Comprehensive Hernia Center- Digestive Disease and Surgery Institute- The Cleveland Clinic Foundation, Cleveland, OH, USA
Abstract :
Background: Umbilical hernias are common in patients with end-stage liver disease undergoing liver
transplantation. Management of those persisting at the time of liver transplantation is important to define.
Objective: To evaluate the long-term results of patients undergoing simultaneous primary umbilical hernia
repair (UHR) at the time of liver transplantation at a single institution.
Methods: Retrospective chart review was performed on patients undergoing simultaneous UHR and liver
transplantation from 2010 through 2016. 30-day morbidity and mortality outcomes and long-term hernia
recurrence were investigated.
Results: 59 patients had primary UHR at the time of liver transplantation. All hernias were reducible with
no overlying skin breakdown or leakage of ascites. 30-day morbidity and mortality included 5 (8%) superficial
surgical site infections, 1 (2%) deep surgical site infection, and 7 (12%) organ space infections.
Unrelated to the UHR, 10 (17%) patients had an unplanned return to the operating room, 16 (27%) were
readmitted within 30 days of their index operation, and 1 (2%) patient died. With a mean follow-up of
21.8 months, 7 (18%) patients experienced an umbilical hernia recurrence.
Conclusion: Despite the high perioperative morbidity associated with the transplant procedure, concurrent
primary UHR resulted in an acceptable long-term recurrence rate with minimal associated morbidity.
Keywords :
Liver transplantation , Umbilical hernia , Surgical technique , Cirrhosis , Clinical decision-making , Liver disease , Tissue injury and repair
