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Non-mesh inguinal hernia repair with early resumption of peritoneal dialysis in patients on continuous ambulatory peritoneal dialysis

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Abstract

Purpose

Inguinal hernia is a common complication of peritoneal dialysis (PD). Although tension-free mesh repair is a leading option for inguinal hernia repair, concerns over serious mesh-related complications may indicate a role for non-mesh inguinal hernia repair. In addition, there is no consensus on the perioperative dialysis regimen. Early resumption of PD may avoid the additional risks associated with hemodialysis. We report on the outcomes of non-mesh inguinal hernia repair in patients on continuous ambulatory PD (CAPD) and provide a perioperative dialysis protocol that aims to guide early resumption of PD.

Methods

Between May 2019 and September 2023, thirty CAPD patients with 43 inguinal hernias who underwent non-mesh inguinal hernia repair were retrospectively analyzed. Data on the patient characteristics, perioperative dialysis regimen, perioperative features, complications, and hernia recurrence were collected and assessed.

Results

Thirty patients with a total of 43 inguinal hernia repairs were included in this study. The median age was 53 years. 23 patients were male and 7 were female. Non-mesh inguinal repair was performed for all patients. PD was resumed at a median of 2 days after the surgery. Five patients received interim hemodialysis. There were no postoperative surgical or uremic complications and no recurrence after a median follow-up of 31.5 months.

Conclusion

Our study demonstrates the effectiveness and safety of non-mesh repair with early resumption of PD in patients on CAPD. Interim HD is unnecessary in selected patients. Choosing the optimal perioperative dialysis regimen is essential to managing inguinal hernias in CAPD patients.

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Authors and Affiliations

  1. Department of Urology, National Taiwan University Hospital, Taipei, Taiwan

    Tsung-Yi Hsieh, Hsiu-Ying Lin & Kuo-How Huang MD, PhD

  2. Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan

    Hsiu-Ying Lin

  3. Department of Urology, College of Medicine, National Taiwan University, Taipei, Taiwan

    Kuo-How Huang MD, PhD

  4. Department of Urology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan

    Kuo-How Huang MD, PhD

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Correspondence to Kuo-How Huang MD, PhD.

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The authors declare no conflict of interest in this study. There was no funding for this study.

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This study was reviewed and approved by the Research Ethics Committee C of the National Taiwan University Hospital (202104051RINC). The study is retrospective in nature and does not involve ongoing human subject studies. Formal consent is not required for this retrospective review.

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This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee.

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Hsieh, TY., Lin, HY. & Huang, KH. Non-mesh inguinal hernia repair with early resumption of peritoneal dialysis in patients on continuous ambulatory peritoneal dialysis. Hernia 28, 615–620 (2024). https://doi.org/10.1007/s10029-024-02960-x

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