• Medicine · Nov 2022

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

    • Leonardo Zumerkorn Pipek, Vitor Santos Cortez, João Victor Taba, Milena Oliveira Suzuki, do NascimentoFernanda SayuriFSFaculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, Brazil., de MattosVitoria CarneiroVCFaculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, Brazil., Walter Augusto Moraes, Leandro Ryuchi Iuamoto, Wu Tu Hsing, Luiz Augusto Carneiro-D'Albuquerque, Alberto Meyer, and Wellington Andraus.
    • Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, Brazil.
    • Medicine (Baltimore). 2022 Nov 11; 101 (45): e31506e31506.

    AbstractThe 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.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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