Recurrent Ventral Hernia's Prevention And Treatment After Hernioplasty
Omarov Nazarbek Bakytbekovich, Kazangapov Rustem Seisenbekovich, Kairkhanov Ernar Karimkhanovich, Imangazinov Sagit Baimukhanovich
The article describes the results of surgical treatment of patients with postoperative ventral hernias. The incidence of postoperative ventral hernias (PVH) in patients with hernias ranges from 3 to 19%; and 20–26% in patients after laparotomy (this is the 2nd place from frequencies after inguinal hernias). More than 4 million laparotomies annually performed in the United States in various diseases cases, and of which 2–30% of patients develop PVH. Hernia repairs occur in 150-250 thousand patients. And recurrences happened in 100 thousand patients, which were operated on again for their . The cost of treating such patients is over $ 2 billion per year. In the Netherlands, according to the national medical registration data, there are about 4 thousand hernioplasty procedures for PVH per 100 thousand laparotomies. In this case, in 57–83% of patients, ventral hernias of median localization are formed. In general, the number of reoperations in patients for recurrent PVH ranges from 2.5 to 54.8%.
Purpose of the work: prevention and treatment of wound complications during hernioplasty of incisional ventral hernias.
Materials and methods: All patients were treated in the department of surgery of the Pavlodar regional hospital named after I.G. Sultanov, city hospitals No.1 and 3 of Pavlodar from 2010 to 2020. The study was dominated by female patients 91 (63%), men 53 (37%). The patients were divided into 2 groups. Observation group (I) 77 (53%) patients were treated according to the proposed improved method with prevention complications. Comparison group (II) consisted of a retrospective sample of 67 (47%) consecutive patients, whose examination and treatment was carried out according to the existing standard.
Results and discussion: Using of autodermal plastics by the developed method reduced the percentage of local postoperative complications from 19.8% to 5.3%, and the frequency of hernia recurrences from 28% to 4.5%, which indicates its effectiveness, especially in patients with large and recurrent hernias.
Conclusion: the developed method is easy to carry out, reduces the risk of wound complications and prevents hernia recurrence.