Post-Operative Lumbar Hernia and Bulge Following Surgical Flank approach(es) to the Kidney; A Study of Related Factors

Abstract

Lumbar hernias occur in the flank and are most often acquired spontaneous, posttraumatic, or postoperative) rather than congenital. Symptoms are absent, variable, or confusing because post incisional neuralgia may be indistinguishable from pain caused by a lumbar hernia. A flank bulge may be detectable, but the clinical diagnosis can be very difficult in obese and postoperative patients. Flank bulge is one of the most common complications of flank approach to the kidney; Post-operative lumbar hernia is also one of the most annoying complications of the renal surgery. So, the present work aimed to determine the peri-operative risk factors for occurrence of both hernia and bulge. The risk factors for occurrence include factors related to patient’s status, underlying disease, surgical technique and postoperative complications. Surgical technique of wound closure also plays a role. Perioperative factors appear to have the most significant correlation to incisional hernia formation, with wound infection being the most consistently reported risk factor. Other perioperative factors include deep abscesses, perioperative gastrointestinal complications and early reoperations. The aim of this study was to evaluate the incidence and risk factors of development of lumbar incisional hernia and flank bulge after lumbar incision. This study was carried out on 150 patients underwent variable renal surgeries through flank approach, 50 of them had incomplete records and excluded from the study, 100 patients were included in this study and the results were presented and analyzed.