Surgical Treatment of Ventral Hernia in the Obese Patients
Nazarbek Omarov, Olga Tashtmarova, Sagit Imangazinov, Kamal Tashtmarov, Rustem Kazangapov
Obesity plays an important role in the occurrence of wound complications in the early postoperative period and relapses in the subsequent hernia repair of postoperative ventral hernias. A comparative analysis of surgical treatment of 82 patients with postoperative ventral hernias, having obesity of varying degrees, using autoplasty and alloplasty to close the hernia gate, has been carried out with the use of clinical and instrumental methods of research. For the diagnosis, the classification of ventral hernias Chevrel-Rath was used, obesity was determined by body mass index. All patients underwent herniotomy in the traditional way. Control examination was carried out after 1, 6, 12 months. Statistical analysis was performed using comparative indicators of wound complications and hernia recurrences, depending on the severity of obesity, and the type of surgical interventions. The study found that overweight in patients with postoperative ventral hernias is an important factor in the development of postoperative wound complications in 17.1% of cases and 6.1% in hernia relapses. The frequency and chances of wound complications in the surgical treatment of postoperative ventral hernias are significantly higher with the III and the IV grade of obesity, predominantly after autoplasty of the hernia gate, while maintaining the risk of hernia recurrence in the late period after surgery.