Cirrhosis and hernia repair in a cohort of 6352 patients in a tertiary hospital: Risk assessment and survival analysis

Medicine (United States) - Tập 101 Số 45 - Trang e31506 - 2022
Leonardo Zumerkorn Pipek1,2,3,4,5, Vitor Santos Cortez1,2,3,4,5, João Victor Taba1,2,3,4,5, Milena Oliveira Suzuki1,2,3,4,5, Fernanda Sayuri do Nascimento1,2,3,4,5, Vitoria Carneiro de Mattos1,2,3,4,5, Walter Augusto Moraes1,2,3,4,5, Leandro Ryuchi Iuamoto1,2,4,5, Wu Tu Hsing1,2,4,5, Lawrence Haddad1,2,6,4,5, Alberto Meyer6, Wellington Andraus1,2,6,4,5
1101:45(e31506).
2All data generated or analyzed during this study are included in this published article [and its supplementary information files].
3Faculdade de Medicina (FMUSP), Universidade de Sao Paulo, São Paulo, Brazil
4How to cite this article: Pipek LZ, Cortez VS, Taba JV, Suzuki MO, do Nascimento FS, de Mattos VC, Moraes WA, Iuamoto LR, Hsing WT, Carneiro-D'Albuquerque LA, Meyer A, Andraus W. Cirrhosis and hernia repair in a cohort of 6352 patients in a tertiary hospital: Risk assessment and survival analysis. Medicine 2022
5Supplemental Digital Content is available for this article.
6Department of Gastroenterology, Hospital das Clínicas, HCFMUSP, São Paulo, Brazil.

Tóm tắt

The prevalence of hernias in patient with cirrhosis can reach up to 40%. The pathophysiology of cirrhosis is closely linked to that of the umbilical hernia, but other types are also common in this population. The aim of this study is to evaluate factors that influence in the prognosis after hernia repair in patients with cirrhosis. A historical cohort of 6419 patients submitted to hernia repair was gathered. Clinical, epidemiological data and hernia characteristics were obtained. For patient with cirrhosis, data from exams, surgery and follow-up outcomes were also analyzed. Survival curves were constructed to assess the impact of clinical and surgical variables on survival. 342 of the 6352 herniated patients were cirrhotic. Patient with cirrhosis had a higher prevalence of umbilical hernia (67.5% × 24.2%, P < .001) and a lower prevalence of epigastric (1.8% × 9.0%, P < .001) and lumbar (0% × 0.18%, P = .022). There were no significant differences in relation to inguinal hernia (P = .609). Ascites was present in 70.1% of patient with cirrhosis and its prevalence was different in relation to the type of hernia (P < .001). The survival curve showed higher mortality for emergency surgery, MELD > 14 and ascites (HR 12.6 [3.79–41.65], 4.5 [2.00–10.34], and 6.1 [1.15–20.70], respectively, P < .05). Hernia correction surgery in patient with cirrhosis has a high mortality, especially when performed under urgent conditions associated with more severe clinical conditions of patients, such as the presence of ascites and elevated MELD.

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Medicine (United States)

Tập 101 Số 45

e31506

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