الفتوق الاندحاقية بعد زرع الكلية و إصلاحها برقعة البرولين الصنعية

Abstract EN

Objective: Renal transplanted patients are at high risk of incisional hernia, especially because of immune suppression drugs.

The aim of this study is to estimate the incidence of incisional hernias after renal transplantation, to define its risk factors, and finally to evaluate the results of these hernia repair using the synthetic prolene mesh.

Methods: A retrospective study has been performed including 320 patients with end-stage renal disease who underwent kidney transplantation from a living donor in the renal transplantation unit at Almouassat University Hospital between 2009 and 2013.

The dossiers of these patients were reviewed to identify the patients who experienced incisional hernia.

the following data were collected from their records: age, gender, weight, diabetes mellitus, graft rejection, surgical technique including muscles splitting while opening the wound, surgical complications that increases wound pressure , treatment method, and treatment results with propylene mesh.

Results: The incidence of incisional hernia was 3.75%, mostly happening during the first year post transplantation.

the rate of these hernias was increased with advanced age, overweight (p=0.002), muscle splitting when opening (p=0.03), whereas there was no role to gender, DM, acute rejection and complications such as lymphocele, heamatomas or urinary leak in the development of incisional hernia.

Conclusion: This study revealed that advanced age especially over 50 years, overweight (body mass index BMI over 30 kg/m2 ) and muscle splitting are risk factors to incisional hernias.

The use of the synthetic prolene mesh to repair these hernias was efficient and not accompanied with increased rate of infections.

A prospective multi centric study could be useful in the future to get a wider sample of patients in order to evaluate all potential risk factors to incisional hernias after renal transplantation to avoid them and ameliorate the results of renal transplantation in our country.