A new modified technique in hernia repair in patients with decompensated cirrhosis and complicated hernia: single center experience

Abstract

Patients with decompensated cirrhosis have a high incidence of abdominal wall hernias To evaluate the outcome of a new technique in the repair of complicated hernias in decompensated cirrhotic patients. Thirty decompensated cirrhotic patients underwent herniorraphy for complicated hernia. Patients were in G I (New technique:15): and II (non-anatomical repair, 15). Patients were followed for one year. Comparable between G I and II regarding age (48.27± 9.51vs. 44.33±9.98, P=0.279), sex [12 males (80%) vs. 12males (80%), P=1], grade of ascites [moderate: 3 (20%) vs. 11 (73.3%) and marked: 12 (80%) vs. 4 (26.6%), P=0.003]. Wound dehiscence and leakage (ascitic fluid) were significantly lower in group I [0% vs. 5 (33.3%), P=< 0.005 and 0% vs. 8 (53.3%), P=0.003, respectively]. In concern to morbidity there is significant difference between GI and II (negative in GI 11(73.3%) vs. 5(33.3%) in GII (P=0.028). The grade of ascites was reduced in GI vs. II [marked: 0% vs. 7 (46.7%), P=0.003]. Postoperative hematemesis was lower in GI {negative in 15(100%) in G I vs. 7(46.7%) in GII and P=0.003)}, and hospital stay was shorter in GI vs. II (6.5±4.0 vs. 12.8±3.0, P< 0.0001). Hernia recurrence was lower in GI at 6 and 12 months [no recurrence in GI 13 (86.67%) vs. G II 5 (35.7%), P=0.014. and no recurrence in GI, 11 (73.33%) vs. G II 4 (28.57%), P=0.011 respectively]. The new technique of hernia repair was associated with a significant reduction in wound leakage, dehiscence, hospital stay, morbidity and recurrence.