Department of Surgery, Queen Mary Hospital, Hong Kong.
Department of Surgery, Tung Wah Hospital, Sheung Wan, Hong Kong.
Perit Dial Int. 2020 Jan;40(1):62-66. doi: 10.1177/0896860819879596.
Peritoneal dialysis (PD) is the first-line renal replacement therapy for end-stage renal failure patients in Hong Kong. Abdominal wall hernia is a common mechanical complication of PD, and early surgical repair has been advocated to reduce complications. This study aims to review the outcomes of tension-free mesh repair of inguinal hernia in PD patients.
All PD patients who underwent elective repair of inguinal hernia from 2009 to 2015 were identified from a single centre for retrospective analysis. Primary outcomes included surgical complications, perioperative dialysis technique and recurrence.
Twenty-one patients with a total of 26 inguinal hernia repairs were included in this 7-year retrospective study. All were males, and the mean age was 68 ± 10 years. Diabetic nephropathy ( = 9, 42.9%) and glomerulonephritis ( = 7, 33.3%) were the two most common causes of renal failure. All hernias were detected after the initiation of PD, and the mean duration of PD to hernia detection was 16 months (range 1-65 months). Lichtenstein open mesh repair was performed in all patients. Complications included seroma ( = 3, 11.5%) and ischaemic orchitis ( = 1, 3.8%). There were no mesh infection or recurrence. Twenty patients (95.2%) received intermittent peritoneal dialysis post-operatively and returned to continuous ambulatory PD in 15 to 30 days. Only one patient (4.8%) required bridging haemodialysis due to Tenckhoff catheter blockage.
Tension-free mesh repair is associated with low morbidity and low recurrence rates in PD patients. Timely management and close collaboration with renal physicians are essential to continue PD after repair.
腹膜透析（PD）是香港终末期肾衰竭患者的一线肾脏替代治疗方法。腹壁疝是 PD 的一种常见机械并发症，早期手术修复已被提倡以减少并发症。本研究旨在回顾 PD 患者无张力网片修补腹股沟疝的结果。
从单一中心回顾性分析 2009 年至 2015 年接受择期修补腹股沟疝的所有 PD 患者。主要结局包括手术并发症、围手术期透析技术和复发。
这项 7 年回顾性研究共纳入 21 例患者，共 26 例腹股沟疝修补术。所有患者均为男性，平均年龄 68 ± 10 岁。糖尿病肾病（n = 9，42.9%）和肾小球肾炎（n = 7，33.3%）是导致肾衰竭的两个最常见原因。所有疝均在开始 PD 后发现，PD 至疝发现的平均时间为 16 个月（1-65 个月）。所有患者均行 Lichtenstein 开放式网片修补术。并发症包括血清肿（n = 3，11.5%）和缺血性睾丸炎（n = 1，3.8%）。无网片感染或复发。20 例患者（95.2%）术后接受间歇性腹膜透析，15-30 天内恢复持续非卧床 PD。仅 1 例患者（4.8%）因 Tenckhoff 导管阻塞需要桥接血液透析。
无张力网片修补术在 PD 患者中具有较低的发病率和复发率。及时管理并与肾脏医生密切合作对于修复后继续 PD 至关重要。
