Our Summary

This study evaluated the safety and results of elective surgical repair of abdominal wall hernias in patients with liver cirrhosis, with a specific focus on those with refractory ascites (a condition where fluid builds up in the abdomen). The researchers looked at medical records from January 2005 to June 2018. They found that among the 107 patients in their study, those with refractory ascites had more advanced liver disease before surgery, but their 30-day survival rate and risk of hernia recurrence were not significantly different from those without refractory ascites. The surgery did not significantly alter key blood tests results in these patients. The conclusion is that elective surgical repair can be a safe way to treat hernias in advanced liver disease patients with refractory ascites. The presence of refractory ascites did not affect the risk of death within 30 days or the chance of the hernia coming back.

FAQs

  1. Is elective surgical repair safe for patients with liver cirrhosis and refractory ascites?
  2. Does the presence of refractory ascites affect the 30-day survival rate or risk of hernia recurrence after surgery?
  3. Does elective surgical repair alter key blood test results in patients with advanced liver disease and refractory ascites?

Doctor’s Tip

A doctor might tell a patient undergoing hernia repair surgery to follow post-operative instructions carefully, including avoiding heavy lifting and strenuous activities until fully healed. They may also advise the patient to maintain a healthy lifestyle, including regular exercise and a balanced diet, to support overall healing and prevent future hernias. Additionally, the doctor may recommend attending follow-up appointments to monitor recovery progress and ensure optimal outcomes.

Suitable For

Patients with liver cirrhosis, particularly those with refractory ascites, are often recommended hernia repair surgery. These patients may have more advanced liver disease before surgery, but elective surgical repair can be a safe and effective way to treat their hernias. The presence of refractory ascites does not significantly affect the risk of death or hernia recurrence after surgery.

Timeline

Before hernia repair:

  • Patient may experience symptoms such as pain, swelling, and discomfort at the site of the hernia
  • Patient may undergo imaging tests such as ultrasound or MRI to diagnose the hernia
  • Patient may be advised to avoid heavy lifting or strenuous activities to prevent worsening of the hernia
  • Patient may consult with a surgeon to discuss treatment options and the risks and benefits of hernia repair

After hernia repair:

  • Patient will undergo surgery to repair the hernia, either through open or laparoscopic techniques
  • Patient may experience some pain and discomfort after surgery, which can be managed with pain medications
  • Patient will need to follow post-operative instructions, such as avoiding heavy lifting and taking care of the incision site to prevent infection
  • Patient will have follow-up appointments with the surgeon to monitor recovery and ensure the hernia does not recur
  • Patient can expect to return to normal activities gradually as they heal from the surgery.

What to Ask Your Doctor

  1. What type of hernia do I have and how severe is it?
  2. What are the potential risks and complications of hernia repair surgery?
  3. What are the different surgical options available for hernia repair and which one do you recommend for me?
  4. How long will the recovery process take and what can I expect in terms of pain and discomfort?
  5. Will I need to make any lifestyle changes or follow a special diet after the surgery?
  6. What is the success rate of hernia repair surgery in patients with liver cirrhosis and refractory ascites?
  7. Will the surgery have any impact on my liver disease or other medical conditions?
  8. How often will I need to follow up with you after the surgery?
  9. Are there any restrictions on physical activity or lifting weights after the surgery?
  10. Are there any signs or symptoms I should watch out for after the surgery that may indicate a complication?

Reference

Authors: Kim SW, Kim MA, Chang Y, Lee HY, Yoon JS, Lee YB, Cho EJ, Lee JH, Yu SJ, Yoon JH, Park KJ, Kim YJ. Journal: Hernia. 2020 Jun;24(3):481-488. doi: 10.1007/s10029-019-02043-2. Epub 2019 Sep 11. PMID: 31512088