PROSTHETIC MESH REPAIR OF MULTIPLE RECURRENT AND LARGE ABDOMINAL-HERNIAS IN CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS PATIENTS

Objective: The aim of this study was to find out whether prosthetic me sh repair of recurrent and large abdominal hernias in continuous ambul atory peritoneal dialysis (CAPD) patients is effective in maintaining them on CAPD. Design: Retrospective analysis of case notes ever a peri od of 5 years. Setting: Single renal unit of a university hospital. Pa tients: Forty-six of 217 CAPD patients (16%) had their hernias repaire d. Among them, 5 women in whom hemodialysis was not possible had multi ple or large hernias repaired with polypropylene (PP) mesh. Results: R adical repair was achieved by a modified operation consisting of a con ventional hernioplasty complemented by a supporting prosthetic overlay mesh, without discontinuation of CAPD. The patients continued CAPD fo r a mean period of 17.6 months without hernia recurrence. Two patients died in the twelfth and fifteenth postoperative month due to cardiac arrest and hepatic failure, respectively, and the remaining 3 are aliv e and have been doing well on CAPD for 13, 14, and 21 months. Conclusi ons: Prosthetic mesh repair of large recurrent hernias in CAPD patient s with vascular access problems seems to be a valuable method to maint ain them on this renal replacement therapy.