The perioperative challenge of umbilical hernias management in chronic liver disease: a multicentric comparative study

IF 0.1 Q4 SURGERY
E. M. Khedr, Selmy Awad, Majed Asiri, Musab AlThomali, Esraa J. Kaheel, Shumukh Alkhammash, Abdullah A Altalhi, Hashim M. Atallah, Hamed A. Alshehri, Nadiah G. Al-Amri, Z. A. Assmary, A. F. Alotaibi, Manal A. Kaabi, A. Alshamrani, Azzah Alzahrani, Malak F. Almogathali, Abdou Salim, A. Tarabay
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Abstract

Background Umbilical hernias are likely to develop in liver cirrhosis patients with ascites as the disease progresses. It is debatable how to handle cirrhotic patients who have an umbilical hernia. Our goal was to examine the perioperative outcome, safety, and efficacy of surgical management of umbilical hernia in ascitic patients using anatomical repair and intraperitoneal mesh repair. Methods 180 patients who reported to between June 2017 and September 2022 with umbilical hernias complaints related to chronic liver disease were included in the study and divided into three groups: − Group A (56 cases) 4 instances were lost to followup, Group B (60 cases), and Group C (60 cases). Results There was a little difference between cases treated surgically and ones treated conservatively. Typically, child B was involved. In group A, 34 patients (60.7%) experienced solitary or combined problems in total. Of these, 14 candidates (25%) involved strangling, eight (14.3%) involved blockage, and twelve (21.4%) involved leaking hernias. Four instances (6.7%) of seroma, four cases (6.7%) of hematoma, twelve cases (20%) of ascitic leak, 32 cases (53.3%) of recurrence, and four cases (5.6%) of encephalopathy were in group B cases. In group C, there were 16 instances (13.3%) of ascetic leak, 12 cases (20%) of wound infection, 12 cases (20%) of seroma, ten cases (16.7%) of recurrence, and four cases (6.7%) of encephalopathy. Conclusion It is advised to do elective treatment for umbilical hernias. mesh reinforcement of abdominal wall hernias is more common as it has a lower risk of hernia recurrence.
慢性肝病脐疝处理的围手术期挑战:一项多中心比较研究
背景:肝硬化腹水患者随着病情的发展,有可能发生脐疝。如何处理有脐疝的肝硬化患者是有争议的。我们的目的是研究腹水患者采用解剖修复和腹膜内补片修复脐疝手术治疗的围手术期结果、安全性和有效性。方法选取2017年6月至2022年9月报告慢性肝病相关脐疝主诉患者180例,分为3组:A组(56例)4例失访、B组(60例)和C组(60例)。结果手术治疗与保守治疗差异不大。一般来说,孩子B也参与其中。在A组,总共有34例(60.7%)患者出现单独或合并问题。其中,14例(25%)涉及绞窄,8例(14.3%)涉及堵塞,12例(21.4%)涉及漏疝。B组血肿4例(6.7%),血肿4例(6.7%),腹水漏12例(20%),复发32例(53.3%),脑病4例(5.6%)。C组有16例(13.3%)腹腔漏出,12例(20%)伤口感染,12例(20%)血肿,10例(16.7%)复发,4例(6.7%)脑病。结论脐疝宜择期治疗。补片加固腹壁疝更为常见,因为它具有较低的疝复发风险。
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