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Management of inguinal herniae in patients on continuous ambulatory peritoneal dialysis: an audit of current UK practice.
  1. G. J. Morris-Stiff,
  2. D. J. Bowrey,
  3. W. A. Jurewicz,
  4. R. H. Lord
  1. Department of Transplant Surgery, University Hospital of Wales, Heath Park, Cardiff, UK.


    Patients receiving continuous ambulatory peritoneal dialysis are at increased risk for the development of inguinal herniae, with a reported prevalence of 14%. Elective hernia repair is indicated for these patients as strangulation is associated with a high mortality in this population. There are currently no national guidelines relating to the optimal peri-operative management of these patients, in particular the appropriate pre- and post-operative dialysis regimen. The aim of the current study was to evaluate current practice in the UK by means of a postal questionnaire sent to all centres undertaking renal transplantation. Replies were received from 34/37 centres. The principal study finding was the wide variation in surgical practice between different centres with regard to pre- and post-operative dialysis regimes. Only 44% of centres had an established protocol. Based upon the study findings we have devised a protocol that we hope to see implemented into UK practice. Following its introduction, a re-assessment will be performed and the audit cycle completed.

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