Tension-free Repair Of Inguinal Hernia With Peritoneal Dialysis

Objectives:To summarize the clinical characteristics of patients with inguinal hernia complicated by abdominal dialysis,and to discuss the perioperative management of tension-free inguinal hernia repair in patients with peritoneal dialysis,and the effect of hernia repair on renal function.Methods:Retrospective analysis of the first affiliated hospital of nanchang university in January 2014-January 2019 peritoneal dialysis combined inguinal hernia line without tension hernia repair of 60 patients with 74 side of clinical data,including patient general condition,operation time,transition way of dialysis,postoperative hospital stay,postoperative complications(scrotal edema,seroma,hematoma surgery area,wound infection),the comparison of preoperative postoperative serum creatinine.To summarize the clinical characteristics of patients with inguinal hernia complicated by abdominal dialysis,and to discuss the perioperative management of tension-free inguinal hernia repair in patients with peritoneal dialysis,and the effect of hernia repair on renal function.Results:Among the 60 patients with peritoneal dialysis complicated with inguinal hernia,the median length of peritoneal penetration was 7 months(1day-3 years).The most common diseases associated with peritoneal dialysis were: hypertension in 50 cases(83.3%),diabetes in 24 cases(40%),anemia in 10 cases(16.7%),hypoproteinemia in 8 cases(13.3%),and hydrocele in 6 cases(10%).General surgical conditions: the average operative time of 46 patients with unilateral hernia was 40.1±5.6min,the average operative time of 14 patients with bilateral hernia was 82.1± 6.7min,and the average postoperative hospital stay was 5.5±3.6 days.The overall incidence of postoperative complications was 31%,scrotal edema in 14 cases(23.3%),wound infection in 4 cases(6.7%),regional seroma in 4 cases(6.7%),and serious postoperative complications(pulmonary infection)in 2 cases(3.3%).Thirty-four patients underwent laparotomy during the transitional period,and 26 patients underwent temporary hemodialysis.No recurrence was found in all patients up to the follow-up deadline..There was no statistically significant difference in serum creatinine before and after surgery(P=0.29).Conclusion:1.Most patients with abdominal dialysis complicated with inguinal hernia are associated with basic diseases,and the most common diseases are hypertension,diabetes,anemia and hypoproteinemia from high to low.2.Strict abdominal examination should be carried out for patients who plan to receive peritoneal dialysis,so as to avoid missing some occult hernias.3.Tension-free herniorrhaphy is safe and effective for PD patients,with no obvious impact on residual renal function.4.In the transitional period after tension-free herniorrhaphy,abdominal dialysis can be continued without increasing hernia recurrence.