Klinisch I - P02 - Incidence, risk factors and treatment of incisional hernia after kidney transplantation; an analysis of 1564 consecutive patients. 


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L.S.S. Ooms, J. Verhelst, J. Jeekel, J.N.M Ijzermans, J.F. Lange, T. Terkivatan

Chair(s): dr. Jan Stephan F. Sanders, internist/nefroloog, UMC Groningen

Thursday 10 march 2016

12:30 - 13:00h at Foyer

Categories: Postersessie

Parallel session: Postersessies XI - Opgesplitst in 3 tijdblokken en 3 categoriëen (klinisch, basaal, donatie)

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Background:
The objective was to evaluate the incidence and treatment of incisional hernia following kidney transplantation, and to identify potential risk factors.

Methods:
A retrospective cohort study was performed. All kidney transplant recipients between 2002 and 2012 were included. Two groups were identified: patients with incisional hernia and patients without. Risk factor analysis for development of incisional hernia was performed.

Results:
A total of 1564 kidney recipients were included. Fifty patients (3.2%) developed incisional hernia. On univariate analysis, female gender (54% vs. 35% p = 0.006), BMI>30 kg/m2 (38 % vs. 17%, p< 0.001), concurrent abdominal wall hernia (30% vs. 16%, p=0.007), multiple explorations of the ipsilateral iliac fossa (38% vs. 19%, p=0.001), left iliac fossa implantation (36% vs 24%, p=0.046), history of smoking (72% vs 57%,p=0.032) and duration of surgery (210 minutes vs. 188 minutes, p=0.020) were associated with the development of incisional hernia. In multivariate analyses female gender (HR 2.6), history of smoking (HR 2.2), obesity (BMI >30) (HR 2.9), multiple explorations of the ipsilateral iliac fossa (HR 2.0), duration of surgery (HR 1.007), and concurrent abdominal wall hernia (HR 2.3) were independent risk factors. Twenty-six of 50 patients (52%) underwent surgical repair, of which nine (35%) required emergency repair.

Conclusions:
The incidence of incisional hernia following kidney transplantation is 3.2%. We found obesity (BMI>30), female gender, concurrent abdominal wall hernias, history of smoking, duration of surgery, and multiple explorations to be independent risk factors for the development of incisional hernia after kidney transplantation. These risk factors should be taken into account to prevent incisional hernia.