Perioperative management of continuous ambulatory peritoneal dialysis patients undergoing inguinal hernia surgery

Abstract

Management of patients undergoing dialysis after inguinal hernia surgery has not been standardized. This report presents the results of 9 patients with inguinal hernias (11 hernias) who were undergoing continuous ambulatory peritoneal dialysis (CAPD). All patients treated in this hospital since 2007 have returned to CAPD within 3 days after surgery without switching to hemodialysis (HD). The mean durations for resuming CAPD after surgery were 7.6 days from 1998 through 2007 and 2.3 days since 2008. The surgical procedure was performed with a polypropylene mesh in all cases. Local anesthesia was utilized for one patient with low cardiac function. All patients recovered rapidly, with no uremia or dialysis-related complications. No leakage or hernia recurrence was observed over the subsequent observation period (56.2 months). This experience suggests the possibility that interim HD can therefore be skipped in patients undergoing CAPD if the hernia sacs are closed tightly. Local anesthesia seems to be safe for high-risk hernia patients undergoing CAPD.

Inguinal hernias in patients on continuous ambulatory peritoneal dialysis: is tension-free mesh repair feasible?

“…In this study, we found no recurrences after tension-free mesh repair for inguinal hernia, including those patients who had early resumption of CAPD after repair, which demonstrates that tension-free mesh hernioplasty for CAPD patients is safe and feasible, which is consistent with the ndings of other studies [5,6,9,10]. Luk et al [6] demonstrated that the Lichtenstein mesh repair remains the gold standard for patients with CAPD.…”

“…Only a few studies, including some case reports, have reported on hernioplasty of inguinal hernias in CAPD patients. Tension-free mesh repair for patients with CAPD has been reported to result in no recurrence [5,[9][10][11] or mesh infection [6].…”

Guidelines for laparoscopic peritoneal dialysis access surgery

“…Comparative trials of open and laparoscopic inguinal hernia repair in PD patients do not exist. However, several reports have used open polypropylene mesh repair of inguinal hernias and shown very low recurrence and leak rates, despite resuming PD within a few days [25][26][27][28].…”

<p>Efficacy of APD in perioperative period of non-abdominal operation for peritoneal dialysis patients</p>

“…7 In patients with ESRD there are many complications, such as high toxin level, malnutrition, anemia, and abnormal coagulation function, so the risk of operation is significantly higher than that of the normal patients, and the mortality in the perioperative period is also significantly higher. 8 In recent years, APD has been reported to be used for emergency dialysis after abdominal wall hernia repair, 9 severe heart failure 10 and new peritoneal dialysis catheter implantation in peritoneal dialysis patients. 11 However, there are few reports on the perioperative application of peritoneal dialysis patients.…”