Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, London, UK.
Department of Surgery, Imperial College London, London, UK.
Hernia. 2024 Dec;28(6):2285-2290. doi: 10.1007/s10029-024-03157-y. Epub 2024 Sep 25.
Incisional hernias (IH) after kidney transplantation (KTx) can cause significant morbidity in kidney transplant recipients (KTR). We aimed to report the outcomes of surgical repair of IH in KTR from our centre.
We retrospectively analysed all the IH repairs in KTR from May 2018 to May 2023. We documented pre-transplant baseline characteristics, peri- and post-KTx events and outcomes and post-IH repair complications. We also documented length of stay, survival, and hernia recurrence post-IH repair.
We performed 35 incisional hernia repairs in 34 KTR from May 2018 to May 2023 with an overall incidence of 1.63% symptomatic IH. Mean patient age was 56.7 ± 10.1 years and mean body mass index (BMI) 29.7 ± 6.49 kg/m. A history of previous hernia operation and open abdominal operations was present in 11.4% and 22.9% of the population, respectively. The types of repairs performed were primary (5.7%), onlay (62.9%), inlay (2.9%) and retromuscular sublay (28.6%). Mean hernia neck size was 8.9 ± 5.6 cm. After IH repair, there was no perioperative mortality with an average 5.5 ± 3.9 days of length of stay. There were seven episodes (20%) of IH recurrence. There was a 6% of superficial wound dehiscence rate and a 3% of surgical site infection. Pearson's correlation test revealed that post-operative hernia recurrence was not related with neck size, post-transplant complications or pre- and post-transplant characteristics, as well as post-transplant outcome.
The recurrence rate in our cohort was 20%. Known risk factors for IH in KTR as well as post-KTx events were not correlated with hernia recurrence or other post-hernia repair complications.
肾移植（KTx）后切口疝（IH）可导致肾移植受者（KTR）出现显著发病率。我们旨在报告我们中心 KTR 中 IH 手术修复的结果。
我们回顾性分析了 2018 年 5 月至 2023 年 5 月期间所有接受 KTx 的 IH 修复患者。我们记录了移植前的基线特征、围手术期和移植后事件以及 IH 修复后的并发症。我们还记录了住院时间、生存率和 IH 修复后的疝复发情况。
我们对 2018 年 5 月至 2023 年 5 月期间 34 名 KTR 进行了 35 次切口疝修复，总 IH 发生率为 1.63%，有症状 IH 发生率为 1.63%。患者平均年龄为 56.7±10.1 岁，平均体重指数（BMI）为 29.7±6.49kg/m。分别有 11.4%和 22.9%的患者有既往疝手术史和开腹手术史。所进行的修复类型为：原发性（5.7%）、衬垫（62.9%）、嵌体（2.9%）和后肌下亚衬垫（28.6%）。平均疝颈大小为 8.9±5.6cm。IH 修复后无围手术期死亡，平均住院时间为 5.5±3.9 天。有 7 例（20%）IH 复发。有 6%的浅表伤口裂开率和 3%的手术部位感染率。Pearson 相关检验显示，术后疝复发与颈围大小、移植后并发症以及移植前和移植后特征以及移植后结果均无相关性。
我们的队列中复发率为 20%。KTR 中 IH 的已知危险因素以及 KTx 后事件与疝复发或其他疝修复后并发症无关。
