School of Medicine, University of Galway, Galway, Ireland.
Dept. of Surgery, St John of God Subiaco Hospital, Subiaco, WA, Australia.
Hernia. 2024 Apr;28(2):301-319. doi: 10.1007/s10029-023-02879-9. Epub 2023 Sep 15.
Incisional hernia (IH) post renal transplant (RT) is relatively uncommon and can be challenging to manage clinically due to the presence of the kidney graft and patient immunosuppression. This systematic review and meta-analysis synthesises the current literature in relation to IH rates, risk factors and outcomes post RT.
PubMed, EMBASE, and Cochrane Central Registry of Controlled Trials (CENTRAL) were searched up to July 2023. The most up to date Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines were followed. Pertinent clinical information was synthesised. A meta-analysis of the pooled proportions of IH rates, the rates of patients requiring surgical repair and the rates of recurrence post RT are reported.
Twenty studies comprising 16,018 patients were included in this analysis. The pooled rate of IH occurrence post RT was 4% (CI 3-5%). The pooled rate of IH repair post RT was 61% (CI 14-100%). The pooled rate of IH recurrence after repair was 16% (CI 9-23%). Risk factors identified for IH development post RT are BMI, immunosuppression, age, smoking, incision type, reoperation, concurrent abdominal wall hernia, lymphocele formation and pulmonary disease.
IH post RT is uncommon and the majority of IH post RT are repaired surgically on an elective basis.
肾移植（RT）后切口疝（IH）相对少见，由于存在肾移植物和患者免疫抑制，临床处理具有挑战性。本系统评价和荟萃分析综合了目前与 RT 后 IH 发生率、危险因素和结局相关的文献。
检索了 PubMed、EMBASE 和 Cochrane 中央对照试验注册中心（CENTRAL）截至 2023 年 7 月的资料。遵循了最新的系统评价和荟萃分析报告的首选条目。综合了相关的临床资料。报告了 RT 后 IH 发生率、需要手术修复的患者比例和复发率的汇总比例的荟萃分析。
本分析纳入了 20 项研究，共 16018 例患者。RT 后 IH 发生率的汇总率为 4%（CI 3-5%）。RT 后 IH 修复的汇总率为 61%（CI 14-100%）。修复后 IH 复发的汇总率为 16%（CI 9-23%）。RT 后 IH 发生的危险因素包括 BMI、免疫抑制、年龄、吸烟、切口类型、再次手术、并发腹壁疝、淋巴囊肿形成和肺部疾病。
RT 后 IH 并不常见，大多数 RT 后 IH 都是择期手术修复的。
