Evaluation of surgical techniques of ventral hernias repair in cirrhotic patients: a cross-sectional study

Background Ventral hernias are defects of ventral aspect of the anterior abdominal wall, which can be congenital or acquired, including epigastric, umbilical, and incisional hernia. Umbilical hernia is present in 20% of cirrhotic patient with ascites. The aim of this work was to assess the outcome of different techniques of closure of ventral hernias in cirrhotic patients. Patients and methods This prospective study was conducted during the period from January 2017 till December 2018. It included 148 cirrhotic patients with ventral hernias. Result Male patients represented 75% of the cases, and female sex 25%. Child A represented 34%, Child B 7%, and Child C 59%. Overall, 90% of cases underwent elective repair, whereas 10% of the patients had urgent repair. Onlay repair was done in 15.6%, retromuscular repair in 29.7%, intraperitoneal onlay mesh sublay repair in 21%, laparoscopic repair in 6%, and retromuscular repair with posterior component separation in 27.7%. Complications were hematoma (4.7%), bleeding (0.7%), wound infection (1.3%), skin erosions by mesh (0.7%), true recurrence (6%), and false recurrence (3.3%). Conclusion Surgical intervention in cirrhotic patient with ventral hernia should be done either elective or emergency, especially after control of ascites. Complications in laparoscopic hernia repair are less than those in open repair and in those with controlled ascites and Child A.