Original CommunicationA prospective study on elective umbilical hernia repair in patients with liver cirrhosis and ascites
Section snippets
Methods
Between July 2004 and May 2010, all patients in the Erasmus University Medical Center with umbilical hernia, cirrhosis, and ascites were included in this study and followed prospectively. Liver failure with cirrhosis was diagnosed on clinical, biochemical, or histologic findings. Ascites was diagnosed with ultrasonography or computed tomography, and umbilical hernia was diagnosed on clinical examination.
All patients included in the study were scheduled for elective hernia repair unless their
Patient characteristics (Table I)
A total of 30 consecutive patients (25 males, 5 females) at a median age of 58.3 years (IQR, 51–65) were included in the elective repair protocol. Of these 30 patients, 7 (23%) were classified as CPT grade A, 18 (60%) as grade B, and 5 (17%) as grade C. The median MELD score was 12 (IQR, 8–16). Of the 30 patients, 6 (20%) had an ASA score of class II, 20 (67%) were class III, and 4 (13%) were class IV. A total of 53% of the patients were on the waiting list for liver transplantation.
Comorbidities of patients in the protocol (Table II)
At the time
Discussion
In this prospective single-center study, the safety of umbilical hernia repair in cirrhotic patients with ascites was investigated in a series of 30 consecutive patients. All patients underwent operations in an elective setting. Previous retrospective studies5, 8 have demonstrated that conservative treatment of umbilical hernia in cirrhotic patients is associated with considerable morbidity and mortality. Hence, prospective series, such as this one, are needed to assess the safety and efficacy
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Cited by (89)
Surgical Risk Assessment in Patients with Chronic Liver Diseases
2022, Journal of Clinical and Experimental HepatologyCitation Excerpt :Minimally invasive alternatives like colonic stent placement in case of obstruction can be considered in high risk cases. On the contrary, elective abdominal wall surgeries like umbilical hernia repair is safer with acceptable risk even in Child class C patients.61 One study reported advance age (>65), Higher MELD (>15), low serum albumin (<3 gm/dl), massive ascites, and presence of esophageal varices as predictors of poor outcome.62
Fix it while you can … Mortality after umbilical hernia repair in cirrhotic patients
2020, American Journal of SurgeryOutcomes of umbilical hernia repair in cirrhotic veterans: a VASQIP study
2023, Langenbeck's Archives of Surgery