Asian Journal of Surgery
Volume 33, Issue 1 , Pages 1-7, January 2010

Optimal Technique for Abdominal Fascial Closure in Liver Transplant Patients

  • Unal Aydin

      Affiliations

    • Department of General Surgery, Gaziantep University School of Medicine, Gaziantep, Turkey
    • Corresponding Author InformationAddress correspondence and reprint requests to Dr Unal Aydin, Department of General Surgery, Gaziantep University School of Medicine, Gaziantep 27080, Turkey

Organ Transplantation and Research Centre, Ege University School of Medicine, Izmir, Turkey

Accepted 30 September 2009.

Article Outline

Background

The ideal technique for abdominal closure of a Mercedes-type incision, which is still a serious issue among surgeons, has yet to be demonstrated clearly. The purpose of this study was to explain our novel technique for abdominal fascial closure in liver transplant patients.

Methods

We analyzed retrospectively 180 consecutive adult-to-adult right lobe living donor liver transplants. The patients were divided into two groups based on two abdominal closure types used. Group A consisted of 78 patients who were submitted to abdominal closure with our new technique using three synthetic absorbable loop suture materials, and group B consisted of 102 patients whose abdominal closure was performed with another type of closure technique.

Results

There were no significant differences between the demographic characteristics of the two groups. The mean closure time was significantly lower in group A than in group B (p <0.05). The incidence rates of ascites leakage and hernias were also significantly lower in group A (p <0.05).

Conclusion

Our results indicate that the novel technique used in this study contributed to overcoming early and late postoperative complications associated with closure of the abdominal fascia in liver transplant patients. In addition, this new technique has proven to be easily applicable, faster, safer and efficient in these patients; it is also potentially useful for conventional surgery.

Key Words:  abdominal fascial closure , Mercedes-type incision , liver transplant

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Ozden I , Emre A , Bilge O , et al.   Elective repair of abdominal wall hernias in decompensated cirrhosis . Hepatogastroenterology . 1998;45:1516–1518
  2. Donataccio M , Genco B , Donataccio D . Right subcostal incision in liver transplantation: prospective study of feasibility . Transplant Proc . 2006;38:1109–1110
  3. Müller V , Lehner M , Klein P . Incisional hernia repair after orthotopic liver transplantation: a technique employing an inlay/onlay polypropylene mesh . Langenbecks Arch Surg . 2003;388:167–173
  4. Wu CC , Yeh DC , Lin MC , et al.   Improving operative safety for cirrhotic liver resection . Br J Surg . 2001;88:210–215
  5. Piazzese E , Montalti R , Beltempo P , et al.   Incidence, predisposing factors, and results of surgical treatment of incisional hernia after orthotopic liver transplantation . Transplant Proc . 2004;36:3097–3098
  6. Rudow DL , Brown RS , Emond JC , et al.   One-year morbidity after donor right hepatectomy . Liver Transpl . 2004;10:1428–1431
  7. Janssen H , Lange R , Erhard J , et al.   Causative factors, surgical treatment and outcome of incisional hernia after liver transplantation . Br J Surg . 2002;89:1049–1054
  8. D'Angelica M , Maddineni S , Fong Y , et al.   Optimal abdominal incision for partial hepatectomy: increased late complications with Mercedes-type incisions compared to extended right subcostal incisions . World J Surg . 2006;30:410–418

PII: S1015-9584(10)60001-2

doi:10.1016/S1015-9584(10)60001-2

Asian Journal of Surgery
Volume 33, Issue 1 , Pages 1-7, January 2010

Article Tools