Incisional Hernias Post Liver Transplantation

Postgraduate Thesis uoadl:2881024 301 Read counter

Unit:
Κατεύθυνση Ελάχιστα Επεμβατική Χειρουργική, Ρομποτική Χειρουργική και Τηλεχειρουργική
Library of the School of Health Sciences
Deposit date:
2019-09-23
Year:
2019
Author:
Garmpis Nikolaos
Supervisors info:
Νικόλαος Νικητέας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Δημήτριος Δημητρούλης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, Επιβλέπων
Γεράσιμος Τσουρούφλης, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Μετεγχειρητικές κήλες μετά από μεταμόσχευση ήπατος
Languages:
English
Translated title:
Incisional Hernias Post Liver Transplantation
Summary:
Background: The occurrence of an incisional hernia after liver transplantation consists a potential complication that may seriously affect the postoperative course and the quality of patient’s life in general.
Objective: The purpose of this study is to report the current epidemiological data, to analyse the risk factors that may lead to post liver transplantation incisional hernia, to evaluate the role of laparoscopic repair in this condition and to present the technical difficulties in the management of this special patient group.
Materials and Methods: A literature search was done through PubMed database. Our criteria included studies in English, looking for incisional post-transplant hernias, open or laparoscopic repair. Finally, we collected 24 relevant studies.
Results: Incisional hernia may happen no matter how the abdominal incision has been done. However, median incisions of the abdomen are documented to have the predominant occurrence. Risk factors predisposing to incisional hernia are both patient and technique-related. Early postoperative development of an incisional hernia suggests the responsibility of local factors such as infection, tension or closure technique. Each occasion should be individually planned and tailored to the patient. Not only should the surgeon consider the special medical circumstances, but also, he must make the best option among the various surgical strategies. Contemporary surgeons can choose between open or laparoscopic repair, using prosthetic mesh or not, synthetic or biologic. Although modern surgery gets even less invasive, still open hernia repair in transplanted people prevails. Relevant literature comparing the two methods show to be competitive when laparoscopic repair is done in experienced centres and in selected occasions. Type of mesh must be used appropriately.
Conclusions: Well organized studies must be conducted to establish the best repair technique and its indications.
Main subject category:
Health Sciences
Keywords:
Incisional, Hernia, Abdominal, Liver, Transplantation
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
24
Number of pages:
47
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