Umbilical hernia repair in patients with cirrhosis: systematic review of mortality and complications
Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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Umbilical hernia repair in patients with cirrhosis : systematic review of mortality and complications. / Snitkjær, C.; Jensen, K. K.; Henriksen, N. A.; Werge, M. P.; Kimer, N.; Gluud, L. L.; Christoffersen, M. W.
I: Hernia, Bind 26, Nr. 6, 2022, s. 1435-1445.Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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TY - JOUR
T1 - Umbilical hernia repair in patients with cirrhosis
T2 - systematic review of mortality and complications
AU - Snitkjær, C.
AU - Jensen, K. K.
AU - Henriksen, N. A.
AU - Werge, M. P.
AU - Kimer, N.
AU - Gluud, L. L.
AU - Christoffersen, M. W.
N1 - Publisher Copyright: © 2022, The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
PY - 2022
Y1 - 2022
N2 - Background: Umbilical hernia is a common and potential serious condition in patients with cirrhosis. This systematic review evaluated the risks associated with emergency and elective hernia repair in patients with cirrhosis. Methods: Systematic review of clinical trials identified through manual and electronic searches in several databases (last update November 2021). The primary random-effects meta-analyses evaluated mortality in patients with or without cirrhosis or following emergency versus elective repair. The quality of the evidence was assessed using GRADE and Newcastle Ottawa Scale. Results: Thirteen prospective and 10 retrospective studies including a total of 3229 patients were included. The evidence was graded as very low quality for all outcomes (mortality and postoperative complications within 90 days). In total 191 patients (6%) died after undergoing umbilical hernia repair. Patients with cirrhosis were more than eight times as likely to die after surgery compared with patients without cirrhosis [OR = 8.50, 95% CI (1.91–37.86)] corresponding to 69 more deaths/1000 patients. Among patients with cirrhosis, mortality was higher after emergency versus elective repair [OR = 2.67, 95% CI (1.87–3.97)] corresponding to 52 more deaths/1000 patients. Postoperative complications were more common in patients with cirrhosis compared with patients without cirrhosis. Conclusion: Patients with cirrhosis undergoing emergency umbilical hernia repair have a considerably increased risk of death and severe complications. Accordingly, additional evidence is needed to evaluate methods that would allow elective umbilical hernia repair in patients with cirrhosis.
AB - Background: Umbilical hernia is a common and potential serious condition in patients with cirrhosis. This systematic review evaluated the risks associated with emergency and elective hernia repair in patients with cirrhosis. Methods: Systematic review of clinical trials identified through manual and electronic searches in several databases (last update November 2021). The primary random-effects meta-analyses evaluated mortality in patients with or without cirrhosis or following emergency versus elective repair. The quality of the evidence was assessed using GRADE and Newcastle Ottawa Scale. Results: Thirteen prospective and 10 retrospective studies including a total of 3229 patients were included. The evidence was graded as very low quality for all outcomes (mortality and postoperative complications within 90 days). In total 191 patients (6%) died after undergoing umbilical hernia repair. Patients with cirrhosis were more than eight times as likely to die after surgery compared with patients without cirrhosis [OR = 8.50, 95% CI (1.91–37.86)] corresponding to 69 more deaths/1000 patients. Among patients with cirrhosis, mortality was higher after emergency versus elective repair [OR = 2.67, 95% CI (1.87–3.97)] corresponding to 52 more deaths/1000 patients. Postoperative complications were more common in patients with cirrhosis compared with patients without cirrhosis. Conclusion: Patients with cirrhosis undergoing emergency umbilical hernia repair have a considerably increased risk of death and severe complications. Accordingly, additional evidence is needed to evaluate methods that would allow elective umbilical hernia repair in patients with cirrhosis.
KW - Cirrhosis
KW - morbidity
KW - mortality
KW - preoperative care
KW - umbilical hernia
U2 - 10.1007/s10029-022-02598-7
DO - 10.1007/s10029-022-02598-7
M3 - Review
C2 - 35412192
AN - SCOPUS:85127958879
VL - 26
SP - 1435
EP - 1445
JO - Hernia : the journal of hernias and abdominal wall surgery
JF - Hernia : the journal of hernias and abdominal wall surgery
SN - 1265-4906
IS - 6
ER -
ID: 319165901