J Korean Surg Soc.  2011 Jun;80(6):420-425. 10.4174/jkss.2011.80.6.420.

Inguinal hernia repair in patients with liver cirrhosis accompanied by ascites

• Hur YH
• Kim JC
• Kim DY
• Kim SK
• Park CY

• KMID: 2212187
• DOI: http://doi.org/10.4174/jkss.2011.80.6.420

Abstract

PURPOSE
We describe the clinical characteristics and assess the outcomes and stability of inguinal hernia repair under local anesthesia for patients with liver cirrhosis accompanied by ascites.
METHODS
We retrospectively reviewed the medical records of 22 patients with cirrhosis and ascites who underwent mesh plug hernia repair performed by a single surgeon from January 2002 to August 2009, and the clinical characteristics and outcomes of the patients were analyzed.
RESULTS
Twenty-two patients were included in the study. Fifteen (68.2%) were Child's class B and seven (31.8%) were Child's class C. Hernia repairs were successful without major complications or recurrence in all patients. Minor complications occurred in only three patients, consisting of two hematomas and one case of scrotal swelling. Complications were resolved spontaneously without the need for blood transfusion or reintervention. Thirteen patients died during follow-up (59.1%); eight of these patients died within 1 year after hernia repair. However, there was no 30-day postoperative mortality. Five of the eight patients who died were Child's class B and the remaining three patients were Child's class C. Deaths were all related to cirrhotic complications, and there was no operation-related mortality.
CONCLUSION
Inguinal hernia repairs under local anesthesia in patients with cirrhosis accompanied by ascites were performed safely and effectively. Therefore, surgical repair is recommended even in patients with refractory ascites and poor hepatic function to prevent life-threatening complications or severe pain and improve quality of life.

Keyword

Inguinal hernia repair; Local anesthesia; Liver cirrhosis; Ascites

MeSH Terms

Anesthesia, Local
Ascites
Blood Transfusion
Fibrosis
Follow-Up Studies
Hematoma
Hernia, Inguinal
Herniorrhaphy
Humans
Liver
Liver Cirrhosis
Medical Records
Quality of Life
Recurrence
Retrospective Studies

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