scholarly journals ANALYSIS OF NONSURGICAL POSTOPERATIVE VENTRAL HERNIA PREDICTORS

2017 ◽  
Vol 34 (6) ◽  
pp. 5-11
Author(s):  
S N Lebedev ◽  
A V Fedoseev ◽  
A S Inyutin ◽  
S Yu Muraviyev
Keyword(s):  
Surgical Treatment ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Prospective Analysis ◽  
Case Histories ◽  
Endoprosthetic Replacement ◽  
Midline Laparotomy ◽  
Urgent Surgery ◽  
Connective Tissue Dysplasia ◽  
Blood Erythrocyte

Aim. The aim of this study was to detect the predictors of the postoperative herniation in midline laparotomy as the most frequent type of approach in urgent surgery. The study included retro-and-prospective analysis of 398 case histories. Analysis was performed according to 45 signs. Materials and methods. The following parameters were taken into account: Kettle index, anterior abdominal wall status, presence of the signs of undifferentiated connective tissue dysplasia, hard physical labour, use of bandage in the postoperative period as well as blood erythrocyte and hemoglobin indices, bilirubin and creatinine levels. Separately, the following parameters were assessed: presence of aponeurosis defects (physically and by US data) and presence of hernia outpouching. Results. According to the obtained data, the indications to preventive endoprosthetic replacement of the anterior abdominal wall were formed. Conclusions. Combination of some factors, not connected with surgical treatment, raises the risk for herniation, being the indication to preventive endoprosthesis replacement of the abdominal wall.

Efficacy evaluation of case-specific approach for surgical treatment of incisional ventral hernia

2021 ◽  
Vol 93 (5) ◽  
pp. 1-5
Author(s):  
Svetlana Sokolova ◽  
Andrey Sherbatykh ◽  
Konstantin Tolkachev ◽  
Vladimir Beloborodov ◽  
Vadim Dulskiy ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Anterior Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Long Term Results ◽  
Treatment Results ◽  
Specific Approach ◽  
Incisional Ventral Hernia

The Aim of research is to improve the results of surgical treatment of incisional ventral hernia by applying a case-specific approach and a new method of plastic repair of anterior abdominal wall. The prospective controlled dynamic study is based on incisional ventral hernia treatment results with the use of meshed endoprostheses among 219 patients. On-lay alloplasty was used in patients younger than 60 years of age, without severe concomitant pathology, with small and medium hernias and anterior abdominal wall defect of up to 10 cm (W1 - W2). The article shows a selection algorithm for anterior abdominal wall plastic repair method. It goes through advantages of the author’s proprietary technique. The article displays frequency and patterns of complications, life quality of the patients after various prosthetic plastic repairs. In the main group, positive treatment results were observed in 65.0%, long-term results of the operation were observed in 88.4%, complications occurred in 13.6%, relapse in 4.5%. «On lay» treatment tactics showed positive results in 59.4%, long-term results of the operation were observed in 74.7%, complications occurred in 40%, relapse in 3.1%. After «sub lay» intervention, excellent results were observed in 40.0% of patients, long-term results of the operation were observed in 81.9%, complications occurred in 12%, and relapse in 1.4%.

scholarly journals Necrotising fasciitis secondary to a colocutaneous fistula

2016 ◽  
Vol 98 (7) ◽  
pp. e130-e132 ◽  
Author(s):  
N Husnoo ◽  
S Patil ◽  
A Jackson ◽  
M Khan
Keyword(s):  
Abdominal Wall ◽  
Diverticular Disease ◽  
Anterior Abdominal Wall ◽  
English Literature ◽  
Previous History ◽  
Necrotising Fasciitis ◽  
Preoperative Imaging ◽  
Sigmoid Colectomy ◽  
Midline Laparotomy ◽  
Colocutaneous Fistula

Colocutaneous fistulae secondary to diverticular disease are rare, especially spontaneous fistulae. We report a case of a 74-year-old lady, with no previous history of diverticular disease, presenting with necrotising fasciitis of the anterior abdominal wall in the left iliac fossa, without any other symptoms. Urgent surgery was performed. An initial diagnostic laparoscopy demonstrated a perforated sigmoid diverticulum forming a fistula to the anterior abdominal wall. Following soft tissue debridement, a sigmoid colectomy was performed through a midline laparotomy. Gastrointestinal pathology should be considered as a potential cause of abdominal wall necrotising fasciitis. Our approach of using laparoscopic visualisation to assess for intra-abdominal sources in this context (in the absence of preoperative imaging when imaging could delay treatment) has not been described before. To our knowledge, only two cases of abdominal wall necrotising fasciitis secondary to diverticular disease with a colocutaneous fistula have been reported in the English literature.

scholarly journals PLASTICS OF THE ANTERIOR ABDOMINAL WALL IN POSTOPERATIVE VENTRAL HERNIA

2021 ◽  
pp. 91-97
Author(s):  
N. Sivets ◽  
◽  
D. Kluyko ◽  
A. Sivets ◽  
D. Holovach ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Plastic Surgery ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Postoperative Period ◽  
Anterior Abdominal Wall ◽  
Treatment Efficiency ◽  
Ventral Hernias

Objective. Improving the postoperative ventral hernias surgical treatment efficiency. Authors of the article define the clinically developed method of plastic surgery of the anterior abdominal wall in postoperative ventral hernia. Operations with this technique were performed in 37 patients. The endoprosthesis used was a polypropylene net made by “Eticon”. In the postoperative period complications took place in 2 (5,4%) patients. Conclusion. The developed method of the anterior abdominal wall plastics effectiveness was established in the article.

scholarly journals The results of surgical treatment of patients with large and complex incisional hernias of the anterior abdominal wall in a multidisciplinary hospital

2018 ◽  
Vol 17 (3) ◽  
pp. 35-44 ◽  
Author(s):  
E. N. Degovtsov ◽  
P. V. Kolyadko ◽  
V. P. Kolyadko ◽  
A. V. Satinov
Keyword(s):  
Surgical Treatment ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Incisional Hernia Repair ◽  
The Body ◽  
Wound Complications ◽  
Postoperative Wound ◽  
Mesh Reinforcement

Objectives. To evaluate the immediate results of surgical treatment of patients with large incisional hernia of the anterior abdominal wall with the use of the mesh implants.Materials and methods. The data were retrospectively collected and analyzed. The study included patients with a large and / or complex incisional hernia. There were 108 patients who underwent incisional hernia repair with mesh reinforcement in the period from 2012 to 2016. In all cases the repairs were made with mesh implants. The average age of patients was (56.4 ± 10.4) years. The body mass index (BMI) was on average (32.6 ± 6.24) kg/m2. The medial localization of the hernia was 102 (94.44%). The width of the hernia defect averaged (12.2 ± 3.7) cm. Implants were placement in onlay positions – 19 (17.6%), sublay – 49 (45.37%), IPOM (Intraperitoneal onlay mesh) – 30 (27.77%) patients, the component separation technique (CST) with mesh reinforcement was used in 10 (9.25%) patients. Active aspiration drainage was performed in 72 (66.66%) patients.Results. The average time for draining the postoperative wound was (5 ± 2.2) days. The number of wound complications was 23 (21.3%), the number of seromas of the postoperative wound prevailed was 16 (14.8%) patients, of which 2 (1.85%) were chronic abdominal wall seromas, hematoma occurred in  2 patients (1.85%), the number of prolonged serous exudation was 7 (6.5%), necrosis of the wound edges occurred in 4 (3.7%) patients. There was no mortality. Reliably more often wound complications occurred in patients with large hernia defects (p = 0.006), and also with an increase in the duration of surgical intervention (p = 0.01). The hospital-stay in patients with complications was significantly greater (p < 0.001), the need for analgesics also increased (p < 0.001).Conclusion. Prevention of wound complications after large and complex incisional hernia repair with mesh reinforcement is an important direction in improving the results of surgical treatment in this category of patients.

scholarly journals Electrical function of the abdominal muscles after combined plastic of extensive median hernias in the context of connective tissue dysplasia

2019 ◽  
Vol 12 (3) ◽  
pp. 152-157
Author(s):  
Radu Railianu
Keyword(s):  
Connective Tissue ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Clinical Signs ◽  
Clinical Severity ◽  
Abdominal Muscles ◽  
Abdominal Hernias ◽  
Connective Tissue Dysplasia ◽  
Optimal Rehabilitation ◽  
Relaxing Effect

Relevance. Improving the electrical function of abdominal muscles in patients with extensive median hernias of the anterior abdominal wall can be facilitated by optimizing the choice of methods for combined hernioplasty, taking into account the clinical severity of connective tissue dysplasia among the hernia carriers. Objective. Study the electrical function of abdominal muscles after the methods of combined hernioplasty of extensive median hernias, taking into account the severity of connective tissue dysplasia among the hernia carriers. Results.  The average numbers of electromyogram frequencies of the abdominal muscles of patients with extensive median hernias from the group without clinical signs of connective tissue dysplasia were almost the same after all the applied methods of combined hernioplasty. The predominance of the rectus muscles electric function over the lateral abdominal muscles among the patients of this group was 33,5 %. Electrofunctional rehabilitation of the abdominal muscles of patients in the second group of examinations depended on the method of combined hernioplasty and changed in the event of an increase or decrease in the severity of connective tissue dysplasia.  The recovery of electroactivity of abdominal muscles in the postoperative period in patients from the second group was more significant with an increase in the number of abdominal muscles applied to aponeuroses and vagina of relaxing sections, which contributed to an increase in mobility and contractility of the musculoaponeurotic layers of the anterior abdominal wall. Conclusions. Thus, with an increase in the severity of connective tissue dysplasia in patients with extensive median abdominal hernias, the method of combined hernioplasty with the most pronounced relaxing effect in relation to the anterior abdominal wall promoted optimal rehabilitation of abdominal muscles.

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