Hussein Elgohary, Ahmed M Nawar, Ahmed Zidan, Ayman M Abdelmofeed, Taher H Elwan, Mohamed I Abourizk and Ahmed M Hussein
Objective: To evaluate the outcome of pre-peritoneal repair of an inguinal hernia on both liver functions and quality of life in cirrhotic patients with ascites.
Background: Patient with liver cirrhosis and ascites exhibit peritoneal distension and so increased the incidence of herniation through weakest points in the anterior abdominal wall. Although the incidence of an inguinal hernia in the patient with liver cirrhosis has not been well documented, it is expected to be higher than the general population.
Patient and Methods: The study included 35 cirrhotic patients with mild to moderate ascites. All patients were treated by large prolene mesh patch through pre-peritoneal approach using single transverse supra-pubic incision. Unilateral cases were treated prophylactically for the non-diseased side. All cases were treated on an elective basis. During the 1st 3 months post-operative, we re-assess liver functions and compare it with preoperative results, quality of life was tested by the end of 6th month postoperative and evaluations of recurrence is done by the end of the follow-up period.
Results: All patients passed a smooth uneventful operative and immediate postoperative course. All patients show no postoperative mortality in the 1st month postoperative. All patients show no post-operative recurrence during follow up period.
Conclusion: Preperitoneal approach for an inguinal hernia in a cirrhotic patient with ascites is safe on liver functions and effective in preventing recurrence.