EN
TÜRKÇE
Poster - 293
An effective alternative for abdominal wall closure following liver transplantation: adapting an adult surgical technique to a pediatric population
Pablo María Ruiz Hernandez, Ana Ramirez Calazans, Francisco Javier Murcia Pascual, Alvaro Naranjo Torres, Rosa María Paredes Esteban
Hospital Universitario Reina Sofía- Córdoba- Spain
INTRODUCTION
Abdominal wall closure following pediatric liver transplantation can represent a significant surgical challenge, often due to the size mismatch between the graft and the recipient. In such cases, prosthetic materials may be required to achieve a tension-free closure.
We present our experience using the "sublay" technique, a method commonly applied in adult surgery but infrequently reported in pediatric patients, for abdominal wall reconstruction.
MATERIALS AND METHODS
A retrospective review was conducted of pediatric patients who underwent liver transplantation and subsequent abdominal wall closure using the "sublay" technique with a resorbable monofilament poly-4-hydroxybutyrate (P4HB) mesh between 2017 and 2024.
Demographic variables, time from transplantation to definitive closure, duration of follow-up and postoperative complications associated with the technique were analyzed.
RESULTS
Of the total 65 transplanted patients, 15 underwent abdominal wall closure using the sublay technique. Of these, 74% were female, with a mean age of 36 months ± 37.44 SD (range: 5–132 months). The average time to definitive closure was 12 days ± 14.75 SD (range: 3–41 days), and the mean follow-up period was 60 months ± 30.89 SD (range: 6–130 months).
Seven of the 15 patients received primary closure using the sublay technique without complications. The remaining eight initially underwent primary closure with conventional methods but developed incisional hernias during follow-up. These patients were subsequently reoperated using the sublay technique, with no postoperative complications or hernia recurrence observed.
CONCLUSIONS
The sublay technique using resorbable mesh provides favorable long-term outcomes and may represent a safe and effective alternative for abdominal wall closure following liver transplantation. Moreover, it may be a valuable strategy in other complex surgical scenarios where spatial constraints pose a challenge for primary closure.