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RACS ASC 2024

Approaches to surgical repair of peritoneal dialysis-related inguinal hernia: A review of current practice

Poster

Poster

Disciplines

Hernia Surgery

Presentation Description

Institution: St. Vincent's Hospital Sydney - New South Wales, Australia

Purpose: Peritoneal dialysis (PD) is a commonly used treatment in patients with end-stage renal failure (ESRD). Inguinal hernia could be identified during PD-catheter placement or following commencement of PD. The aim of this study is to review the current surgical practice in PD-related inguinal hernia. Methodology: Literature search were conducted using PUBMED and EMBASE using the keywords “peritoneal dialysis”, “inguinal hernia”, and “hernia repair”. Only published studies were included. Results: Six studies were identified following the search. Four of them prospective observational studies, two retrospective observational studies. A total of 91 patients were identified as having PD-related inguinal hernia. 69 patients were identified to have undergone unilateral inguinal hernia repair, whilst 22 patients underwent bilateral inguinal hernia repair. Lichtenstein hernia repair were used in five studies (n= 79), and one study examined the trans-abdominal pre-peritoneal approach (TAPP). The commonest post-operative complications were seroma formation (n=5), and haematoma (n=2). One case of PD-catheter candida infection was reported 1-month post-op, resulting in removal of PD-catheter. There were no reported mesh-related infections. The duration from operation to resuming peritoneal dialysis ranges from day 1 post-op, to day 10 post-op. Conclusion: Open inguinal hernia repair with mesh, in particular, Lichtenstein hernia repair, remain the most common surgical approach in patients with PD-related inguinal hernia. The reported risk of post-operative mesh infection is low. Further research is required to evaluate the outcomes of laparoscopic approaches in PD-associated inguinal hernia management.

Speakers

Authors

Authors

Dr Xinyi Zhang - , Dr Joel Rabindran - , Prof Reginald Lord -