Surgical treatment of giant incisional ventral hernias with modified polypropylene mesh
Journal Title: Хірургія України - Year 2019, Vol 0, Issue 1
Abstract
The aim — to improve the results of surgical treatment of giant incisional ventral hernias (GIVH) with the Ramirez operation in combination with modified polypropylene mesh. Materials and methods. The surgical treatment analysis of 142 patients with GIVH has been performed. Depending on the type of mesh used during surgical treatment, patients were divided into 2 groups. In 71 (50 %) of group I patients, the component separation technique by Ramirez in combination with the «onlay» alloplasty with the modified polypropylene mesh was performed. In the 2nd group in 71 (50 %) patients the component separation technique by Ramirez in combination with «onlay» alloplasty using the classic polypropylene mesh was used. Results and discussion. Statistically significant better results were obtained in patients of group І compared to group II: seroma revealed in 23 (32.4 %) in group II compared to 5 (7.0 %) in group I (p < 0.05), respectively, the suppuration of the postoperative wound — from 6 (8.5 %) to 1 (1.4 %) (p < 0.05), inflammatory infiltrate — from 9 (12.7 %) to 1 (1.4 %) (p < 0.05). The terms of stay of patients of group ІІ on inpatient treatment — 12 ± 2.3 days, group ІІ — 7 ± 1.2 days. Longterm results: ligature fistulas of the anterior abdominal wall were detected in 4 (6.3 %) patients of group II, in patients of group I of the ligature fistulas were not detected (p < 0.05), meshoma — in 2 (3.2 %) of patients in group ІІ, in group І there was no stir (p > 0.05). Chronic pain in the abdominal wall in 6 — 8 months after surgery was observed in 5 (7.9 ± 0.5 %) patients in group ІІ and in 1 (1.6 %) group І (p > 0.05), recurrences of hernia were found in 6 (9.5 %) patients of group ІІ, in group І — in 1 (1.6 %) (р < 0.05). Conclusions. Surgical treatment of GIVH by the anterior method of the anatomical abdominal wall components separation in combination with the onlay technique using a modified polypropylene mesh is more effective than using the classic polypropylene mesh, as evidenced by a decrease in seroma frequency from 32.4 ± 1.0 to 7.0 ± 0.4 %, suppuration of the postoperative wound — from 8.5 ± 0.4 to 1.4 ± 0.2 %, inflammatory infiltrate — from 12.7 ± 0.5 to 1.4 ± 0.2 %, ligature fistulas of the anterior the abdominal wall — from 6.3 ± 0.4 to 0 %, meshoma — from 3.2 ± 0.3 to 0 %, chronic postoperative pain — from 7.9 ± 0.5 to 1.6 ± 0.2 %, hernia recurrence — from 9.5 ± 0.5 to 1.6 ± 0.2 %.
Authors and Affiliations
Ya. P. Feleshtynsky, R. A. Lutkovskyy, V. V. Smishchuk, V. F. Vatamaniuk
Keywords
Related Articles
- EP ID EP564641
- DOI 10.30978/SU2019-1-39
- Views 130
- Downloads 0
Comparative effectiveness evaluation of the improved and conventional perioperative antithrombotic therapy in patients with acute calculous cholecystitis and concomitant ischemic heart disease
The aim — to evaluate the efficacy of improved perioperative antithrombotic therapy in patients who underwent laparoscopic cholecystectomy for acute calculous cholecystitis (ACH) with concomitant ischemic heart disease (...
The primary diagnostic endoscopic methods for connective tissue diseases verification in patients with respiratory manifestations
The aim — to conduct a retrospective analysis of the connective tissue diseases diagnosis in 47 patients of different ages with respiratory manifestations. Materials and methods. A clinical analysis of the first diagnos...
Individualized treatment for chronic hemorrhoids
The aim — to improve the surgical treatment results in patients with chronic hemorrhoids with individual approach. Materials and methods. The study included 385 patients divided into three groups. In the main group (n =...
Experience with pentotren in patients with obliterating peripheral arteries diseases
The aim — to improve the treatment results of patients with obliterating atherosclerosis of the arteries of the lower extremities. Materials and methods. The examination and treatment results of 50 patients aged 45 to 8...
Inguinal hernias recurrence: causes and surgical treatment
The current paper reveals the definition and classification of recurrent inguinal hernia, the main causes of relapses are highlighted. According to modern data, the relapse causes are divided into three groups: factors c...