Hernia repair and simultaneous continuous ambulatory peritoneal dialysis (CAPD) catheter implantation: feasibility and outcome

Abstract

Background

Occurrence of abdominal wall hernias during and before peritoneal dialysis constitutes a pivotal role in treatment discontinuation, failure, and exclusion from this dialysis method. We herein present a single-center experience regarding a one-stage surgical strategy, including hernia repair and simultaneous peritoneal dialysis catheter implantation.

Patients and methods

Over a 4-year period, 123 patients underwent peritoneal dialysis catheter implantation and 23 patients (19%) had concomitant abdominal wall hernias and were enrolled in this monocentric prospective study. Data collection included recurrent and new-onset hernias, surgical site infection, 1-year and 2-year catheter survival.

Results

In 23 patients, 27 hernia repairs combined with peritoneal dialysis catheter implantation were performed. Median age was 52 years (range, 30–85 years) and 18/23 (78%) patients were male. There were no recurrent hernias and no early surgical site infections. Daily flushing was regularly started on the 1st to 3rd postoperative day. Five patients (22%) developed hernias on other anatomical sites, which required hernia repair and perioperative discontinuation of peritoneal dialysis. After a median follow-up of 37 months (range, 28–87 months), 96% of all implanted catheters were still working.

Conclusion

Hernia repair and simultaneous peritoneal dialysis catheter implantation are associated with no recurrent hernias, an early start of peritoneal dialysis, a very low postoperative morbidity and very high 1-year and 2-year catheter survival.

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Authors

Contributions

CT and KT: development of study design, critical review of the manuscript, analysis, and interpretation of data. PH: acquisition of data, drafting of the manuscript, analysis, and interpretation of data. AK and TM: critical review of the manuscript.

Corresponding author

Correspondence to C. Thiel.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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The procedures describes in this study were in accordance with the ethical standards of the responsible committee on human experimentation.

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Informed consent was obtained from all individual participants included in the study.

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Horvath, P., Königsrainer, A., Mühlbacher, T. et al. Hernia repair and simultaneous continuous ambulatory peritoneal dialysis (CAPD) catheter implantation: feasibility and outcome. Hernia 24, 867–872 (2020). https://doi.org/10.1007/s10029-019-02086-5

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Keywords

  • Peritoneal dialysis
  • Hernia repair
  • Recurrent hernia