Weiss Sascha, Weissenbacher Annemarie, Sucher Robert, Denecke Christian, Brandl Andreas, Messner Franka, Oellinger Robert, Schneeberger Stefan, Schmid Thomas, Pratschke Johann, Biebl Matthias
Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria.
Department of General, Visceral and Transplantation Surgery, Charite Universitätsmedizin Berlin, Berlin, Germany.
Clin Transplant. 2015 Oct;29(10):866-71. doi: 10.1111/ctr.12558. Epub 2015 Aug 21.
Incisional hernia is a common complication after liver transplantation (LT). Immunosuppression, obesity, and use of steroids are known risk factors. The purpose of the retrospective study was to summarize and evaluate experiences and results of laparoscopic intraperitoneal onlay mesh (IPOM) hernia repair.
We reviewed our liver transplant patients over a seven-yr period with laparoscopic incisional hernia repair (LIHR) to direct our attention on risk factors for hernia recurrence after hernia repair.
Fifty-four patients after LT with incisional hernia were treated with laparoscopic repair, 42 male and 12 female patients of overall mean age of 58 ± 9 yr and body mass index (BMI) of 25 ± 4 kg/m(2) . A total of 755 LTs were performed at our institution in this time period, resulting in 7.15% of patients undergoing laparoscopic hernia repair. The mean postoperative hospital stay after was nine d. During the follow-up, nine recurrent hernias were noted (17%). BMI (p = 0.001) and sirolimus as immunosuppressive therapy were significantly associated with hernia recurrence (p = 0.014).
LIHR is a safe and feasible method to treat hernias after LT. BMI and sirolimus as immunosuppressive therapy are risk factors for recurrence of hernia after laparoscopic hernia repair.
切口疝是肝移植（LT）后常见的并发症。免疫抑制、肥胖和使用类固醇是已知的危险因素。本回顾性研究的目的是总结和评估腹腔镜腹腔内补片修补术（IPOM）治疗疝的经验和结果。
我们回顾了7年间接受腹腔镜切口疝修补术（LIHR）的肝移植患者，以关注疝修补术后疝复发的危险因素。
54例LT术后合并切口疝的患者接受了腹腔镜修补术，其中男性42例，女性12例，总体平均年龄为58±9岁，体重指数（BMI）为25±4kg/m²。在此期间，我们机构共进行了755例LT手术，导致7.15%的患者接受了腹腔镜疝修补术。术后平均住院时间为9天。随访期间，发现9例复发性疝（17%）。BMI（p = 0.001）和作为免疫抑制治疗的西罗莫司与疝复发显著相关（p = 0.014）。
LIHR是治疗LT术后疝的一种安全可行的方法。BMI和作为免疫抑制治疗的西罗莫司是腹腔镜疝修补术后疝复发的危险因素。
