Safety and effectiveness of umbilical hernia repair in patients with cirrhosis

Purpose Umbilical hernia is a common complication in patients with cirrhosis. Early studies have reported a high morbidity and mortality associated with hernia repair. The traditional approach has been to non-operatively manage umbilical hernias in patients with cirrhosis. There are emerging data su...

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Bibliographic Details
Published in:Hernia : the journal of hernias and abdominal wall surgery 2018-10, Vol.22 (5), p.759-765
Main Authors: Hew, S., Yu, W., Robson, S., Starkey, G., Testro, A., Fink, M., Angus, P., Gow, P.
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adult
Aged
Aged, 80 and over
Case-Control Studies
Cirrhosis
Elective Surgical Procedures
Emergencies
Female
Hernia
Hernia, Umbilical - complications
Hernia, Umbilical - surgery
Hernias
Humans
Length of Stay - statistics & numerical data
Liver cirrhosis
Liver Cirrhosis - complications
Liver diseases
Male
Medicine
Medicine & Public Health
Middle Aged
Morbidity
Mortality
Original Article
Postoperative Complications
Prospective Studies
Surgical Mesh
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Summary:Purpose Umbilical hernia is a common complication in patients with cirrhosis. Early studies have reported a high morbidity and mortality associated with hernia repair. The traditional approach has been to non-operatively manage umbilical hernias in patients with cirrhosis. There are emerging data suggesting that an elective repair is a preferable approach. This study examined the outcomes of umbilical hernia repair in patients with advanced liver disease and compared this with a control group of non-cirrhotic patients. Methods Prospective data were collected regarding the outcome of umbilical hernia repairs performed between 2004 and 2013 at the Austin Hospital, Melbourne, Australia. Outcomes at 90 days were compared between patients with and without cirrhosis. Results 79 patients with cirrhosis and 249 controls were analysed. Of the patients with cirrhosis, 9% were classified as Child–Pugh A, 61% were Child–Pugh B and 30% were Child–Pugh C. Emergency repairs for complicated hernias was undertaken in 18% of the cirrhosis population and 10% in controls ( P  = 0.10). Post-operative complications occurred more commonly in patients with cirrhosis (26%) compared with controls (11%) ( P  
ISSN:1265-4906
1248-9204
DOI:10.1007/s10029-018-1761-9