UMBILICAL HERNIA IN CIRRHOTIC PATIENTS: OUTCOME OF ELECTIVE REPAIR | ||||
| Journal of the Egyptian Society of Parasitology | ||||
| Article 6, Volume 43, Issue 3, December 2013, Page 609-616 PDF (201.32 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/jesp.2013.93296 | ||||
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| Authors | ||||
| ADEL LASHEEN1; HATEM M. NASER2; AHMED ABOHASSAN3 | ||||
| 1Departments of General Surgery, Faculty of Medicine, Al-Azhar University, Nasr City, Egypt. | ||||
| 2Departments of Anesthesia & ICU, Faculty of Medicine, Al-Azhar University, Nasr City, Egypt. | ||||
| 3Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Nasr City, Egypt. | ||||
| Abstract | ||||
| Cirrhotic patients with umbilical hernia have an increased likelihood of complications following repair. The aim of this study was to assess the outcomes of elective umbilical hernia repair in cirrhotic patients. Fifty patients having uncomplicated umbilical hernia with a cirrhotic liver were studied prospectively. These patients divided into three groups’ according to Child–Turcotte–Pugh (CTP) classification. After management of coagulopathy, correction of hypoalbuminaemia and electrolytes imbalance, and control of ascites, all patients underwent elective hernia repair under regional anesthesia. A comparison was made between the three groups as regard the size of the defect in the linea Alba, operative time, postoperative morbidity and mortality, length of hospital stay, time of return to daily life and postoperative changes in liver function tests (LFTS) in relation to the regional anesthesia applied. hernioplasty was done under spinal anesthesia in 13 patients (26%), under epidural anesthesia in 10 patients (20%), under intercostal nerve block in 7 patients (14%), and under local anesthesia in 20 patients (40%). There was an increased safety (less changes in LFTS) in cases done under local anesthesia and intercostal nerve block. The overall complications rate was 30%. There was an increased complications rate towards the decompensated cases. The differences in the mean length of hospital stay and mean time of return to daily life are statistically significant between the three groups. Umbilical hernia recurrence rate was 2% and no mortality was reported in the study groups. | ||||
| Keywords | ||||
| Umbilical hernia; cirrhotic liver; elective repair | ||||
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