Transversus abdominis muscle release for repair of complex incisional hernias in kidney transplant recipients - 18/06/15
, Sean B. Orenstein, M.D., Cory N. Criss, M.D., Edmund Q. Sanchez, M.D., Michael J. Rosen, M.D., Kenneth J. Woodside, M.D., Yuri W. Novitsky, M.D.Abstract |
Background |
Incisional hernias in kidney transplant recipients (KTRs) can be complex because of adjacent bony structures, proximity of the allograft/transplant ureter, and context of immunosuppression. We hypothesized that our novel posterior component separation with transversus abdominis muscle release (TAR) and retromuscular mesh reinforcement offers a safe and durable repair.
Methods |
KTRs with incisional hernias repaired using the aforementioned technique were identified within our prospective database (2007 to 2013) and analyzed.
Results |
Eleven patients were identified (median age 49 years, body mass index 32). The median hernia size was 30 cm2 (range 88 to 1,040 cm2) and 8 of the 11 patients were recurrent. Intraoperative morbidity consisted of one transplant ureter injury repaired primarily over a stent. Postoperative morbidity consisted of 2 superficial surgical site infections that resolved and 1 readmission for a blood transfusion. There were no instances of mesh infection, explantation, graft loss, or graft dysfunction. With a median follow-up of 12 months (range 3 to 69), 1 (9%) lateral recurrence has been documented.
Conclusions |
For complex incisional hernias in KTRs, TAR is associated with low perioperative morbidity and durable repair.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Novel technique for incisional hernia repair in patients with a kidney allograft. |
• | Demonstrates that the TAR technique is safe and durable. |
• | Acceptable wound morbidity. |
• | No compromise in graft function. |
Keywords : Kidney transplant, Ventral hernia, Transversus abdominis release, Flank hernia, Abdominal wall reconstruction, Posterior component separation
Plan
| The authors declare no conflicts of interest. |
Vol 210 - N° 2
P. 334-339 - août 2015 Retour au numéro
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