Groin hernia in the patients receiving CAPD
Smietański, M.; Renke, M.; Bigda, J.; Smietańska, I.; Wujtewicz, M.; Rutkowski, B.ła.; Sledziński, Z.
Wiadomosci Lekarskie 58(9-10): 553-556
2005
ISSN/ISBN: 0043-5147 PMID: 16529069 Document Number: 594218
Continuous ambulatory peritoneal dialysis (CAPD) is a popular way of treatment of the patients with renal failure. There were 1365 patients on CAPD in Poland in the year 2001. Higher frequency of groin and abdominal hernias was reported in those patients. 10% of dialysed patients developed hernia in the first five years of the therapy. The main problems of hernia repair in the CAPD patients are: increased pressure in abdominal cavity caused by dialysate volume, higher risk of peritonitis, poor prognosis in the complicated cases temporarily or permanently converted to hemodialysis (HD) and the insufficiency of healing process. Complications accorded to hernia repair are the third most often reason of conversion to HD. Conducted studies on hernia repair did not lead to the introduction of the world standard. Authors propose to introduce an unified protocol to improve treatment results. Main guidelines of hernia treatment in CAPD patients are: 1) consultation of the surgeon cooperating with dialysis center in qualification to CAPD, and in the case of hernia symptoms in CAPD patients, 2) application of tension-free methods (PHS recommended), 3) administration of antibiotic prophylaxis, 4) application of local or epidural anesthesia, 5) no necessity of discontinuation of CAPD procedures.