Todd Hf, Diaz D, Roth Js
University of Kentucky College of Medicine, Lexington, USA.
J Surg Case Rep. 2012 Sep 1;2012(9):18. doi: 10.1093/jscr/2012.9.18.
Separation of components technique for incisional hernia repair is increasingly utilized as a strategy for hernia repair in both the obese and those with loss of abdominal domain. Endoscopic component separation technique [ECST] is increasingly performed to minimize wound complications associated with the open procedure. We present a case of a patient who developed acute renal failure related to rhabdomyolysis following ECST. A 62-year-old morbidly obese female with BMI of 46 underwent ECST hernia repair for a large midline hernia with loss of domain. Postoperatively, she was found to be oliguric with a dark brown colored urine, elevated serum creatinine and blood urea nitrogen, and increased urine myoglobin levels. She recovered with aggressive hydration and urine alkalinization. We present this unique complication and review the literature.
切口疝修补的成分分离技术越来越多地被用作肥胖患者和腹部区域缺失患者疝修补的一种策略。内镜下成分分离技术(ECST)越来越多地被应用,以尽量减少与开放手术相关的伤口并发症。我们报告一例患者,在接受ECST后发生与横纹肌溶解相关的急性肾衰竭。一名62岁的病态肥胖女性,BMI为46,因巨大中线疝伴区域缺失接受了ECST疝修补术。术后,发现她少尿,尿液呈深棕色,血清肌酐和血尿素氮升高,尿肌红蛋白水平增加。通过积极补液和尿液碱化,她康复了。我们介绍了这一独特的并发症并回顾了相关文献。