Abstract：Objective: To understand the occurrence of severe incisional hernia after renal transplantation and analyze the risk factors that affect the occurrence of it. Methods: Retrospective analysis of the clinical data of 827 patients who underwent the allograft kidney transplantation from Aug. 2005 to Aug. 2015, according to the occurrence of severe incisional hernia after operation, They were divided into incisional hernia group and non incisional hernia group, including 25 cases of incisional hernia group and 802 cases of non incisional hernia groups, the clinical data and renal transplantation data of the two groups were compared, and the factors that affected the severe incisional hernia after renal transplantation were analyzed by Cox multiple factor regression analysis. Results: ①In this study, 25 cases of postoperative severe incisional hernia occurred in 827 patients with renal transplantation, the incidence rate was 3.02%. ②The difference between the incisional hernia group and non incisional hernia group was not statistically significant in age, gender, chronic kidney disease history, diabetes and hypertension before transplantation, steroid induced diabetes, first transplantation, organ donation type, operation time, senior surgeon, fascia closure suture, the way of closing the abdomen, incision hernia history and peritoneal dialysis history (P > 0.05), there was a statistically significant difference in body mass index (BMI), smoking, abdominal operation history, surgical incision, incision infection, postoperative low albumin, postoperative taking immunosuppressive agents and lymphatic cyst after transplantation between the two groups (P < 0.05). ③Multivariate Cox multiple factor regression analysis showed that obesity, smoking and lymphatic cyst after transplantation were independent risk factors for severe incisional hernia after renal transplantation. Conclusion: Obesity, smoking and lymphatic cysts after transplantation are independent risk factors for severe incisional hernia after renal transplantation.
[1] 吴国刚,刘吉盛,李博,等.肾移植术后移植肾早期失功能并切口疝1例[J].中华疝和腹壁外科杂志:电子版,2016,10(2):157~158. [2] 刘霞,张培建.腹部切口疝的诱因分析与治疗进展[J].国际外科学杂志,2013,40(9):615~618. [3] 谢颂状.腹壁切口疝发病诱因与治疗研究进展[J].中华实用诊断与治疗杂志,2016,30(10):946~949. [4] 葛均波,徐永健.内科学[M].第8版.人民卫生出版社,2013. [5] 崔勇,王光策,陈铸,等.肾移植术后输尿管梗阻12例临床分析[J].中国中西医结合肾病杂志,2016,17(2):153~154. [6] Luc G, David A, Couzi L, et al. Lateral incisional hernia after renal transplantation: a comparative study.[J]. World Journal of Surgery, 2014, 38(11):2791~2796. [7] Parsikia A, Durinka J, Ortiz J, et al. Incisional hernia after kidney transplantation[J]. Journal of Surgical Research, 2014, 186(2):509. [8] 曹廷宝,韩晓鹏,李三党,等.腹腔镜下疝修补术治疗肥胖患者巨大切口疝21例的经验总结[J].中华疝和腹壁外科杂志:电子版,2015,9(4):302~305. [9] 袁野,曹钧,张杨.腹腔镜下切口疝修补术后复发危险因素分析[J].腹部外科,2015,28(5):346~349. [10] 王松松,苏艳华,谭晓杰,等.手辅助腹腔镜结直肠癌术后切口疝的发生危险因素分析[J].腹腔镜外科杂志,2013,18(2):121~123. [11] Nashan B, Citterio F. Wound healing complications and the use of mammalian target of rapamycin inhibitors in kidney transplantation: a critical review of the literature[J]. Transplantation, 2012, 94(6):547~549.
2018, Vol. 24 
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