Comparative analysis of surgical interventions for postoperative ventral hernia in obese patients
Keywords:laparoscopic hernia repair, incisional ventral hernia, open hernia repair, body mass index
The problem of surgical treatment of postoperative ventral hernias remains relevant today. Currently, a large number of methods of surgical interventions for hernias of the anterior abdominal wall have been proposed, the variety of which requires systematization and analysis of the immediate and distant results of treatment. Goal: to analyze the effectiveness of laparoscopic hernia repair in patients with postoperative ventral hernia with a body mass index of 30 kg/m2. The results of treatment of 29 patients with postoperative ventral hernia were analyzed. Men – 8 (27.5%), women – 21 (72.5%). In 16 (55.2%) patients (main group) laparoscopic intraperitoneal onlay mesh – IPOM was performed, in 13 (44.8%) patients (comparison group) open hernia repair with fixation of the mesh graft in the Sublay position was performed. The analysis of the duration of the surgical intervention indicates that with open hernia repair, there is a significant increase in the duration of the surgical intervention, p˂0.0001. Comparison of the duration of operations in both groups depending on the body mass index also indicates the dependence of the duration of surgery on this indicator. Thus, in the comparison group, there was a tendency to an increase in the duration of the operation with an increase in the body weight of patients with a significant difference in the duration of the operation between the main group and the comparison. The duration of a patient's stay in the hospital and the occurrence of respiratory complications correlates with the level of postoperative pain and the duration of surgery. Postoperative complications in the form of fluid accumulations in the wound area of the abdominal wall depend on the method of surgery and the location of the mesh graft. The use of laparoscopic – IPOM in obese patients significantly improves the results of surgery by reducing the level of postoperative pain, shortening the duration of surgery, and the absence of complications in the early and late postoperative period. When choosing the method of surgical intervention in patients with postoperative ventral hernia, laparoscopic IPOM should be preferred.
Krivoruchko IA, Chugai VV, Sivozhelizov AV. [Laparoscopic plastic surgery of inguinal hernias. Clinical surgery]. 2017;1:5-8. Ukrainian.
Guryanov VG, Lyakh YE, Pariy VD, Korotky OV, Chaly OV, Chaly KO. Handbook of Biosta¬tistics. Analysis of the results of medical research in the package EZR (R – statistics). YaV. Workshop: Textbook: К. Vvistka; 2018. p. 208.
Sivozhelizov AV, Chugai VV, Kolesnyk VP. [Complications of laparoscopic hernioplasty]. Ukrainian Journal of Surgery. 2015;1-2:641-3. Ukrainian.
Ahonen-Siirtola M, Rautio T, Ward J. Com¬plications in Laparoscopic Versus Open Incisional Ventral Hernia Repair. A Retrospective Comparative Study. World Journal of Surgery.
;39(12):2872-7. doi: https://doi.org/10.1007/s00268-015-3210-6
Caruso F, Ciccarese F, Cesana G. Massive Incisional Hernia Repair with Parietex: Monocentric Analysis on 500 Cases Treated with a Laparoscopic Approach. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2017;27(4):388-92. doi: https://doi.org/10.1089/lap.2016.0623
Chelala E, Baraké H, Estievenart J. Long-term outcomes of 1326 laparoscopic incisional and ventral hernia repair with the routine suturing concept: a single institution experience. Hernia. 2016;20:101-10. doi: https://doi.org/10.1007/s10029-015-1397-y
Chevrel JP, Rath AM. Classification of incisional hernias of the abdominal wall. Hernia. 1999;4(1):1-7. doi: https://doi.org/10.1007/BF01230581
Kouhia S, Vironen J, Hakala T. Open Mesh Re¬pair for Inguinal Hernia is Safer than Laparoscopic Repair or Open Non-mesh Repair: A Nationwide Registry Study of Complications. World J of Surgery. 2015;39(8):1878-84.
Light D, Bawa S. Trans-fascial closure in laparoscopic ventral hernia repair. Surgical Endoscopy. 2016;30(12):5228-31. doi: https://doi.org/10.1007/s00464-016-4868-z
Mercoli H, Tzedakis S, D'Urso A. Postoperative complications as an independent risk factor for recurrence after laparoscopic ventral hernia repair: a prospective study of 417 patients with long-term follow-up. Surgical Endoscopy. 2017;31:1469-77. doi: https://doi.org/10.1007/s00464-016-5140-2
Patterson T, Currie P, Patterson S. Systematic review and meta-analysis of the post-operative adverse effects associated with mosquito net mesh in comparison to commercial hernia mesh for inguinal hernia repair in low income countries. Hernia. 2017;21(3):397-405. doi: https://doi.org/10.1007/s10029-017-1608-9
Salgaonkar H, Wijerathne S, Lomanto D. Managing complications in laparoscopic ventral hernia. Ann Laparosc Endosc Surg. 2019;10-11. doi: https://doi.org/10.21037/ales.2019.01.04
Stetsko T, Bury K, Lubowiecka I. Safety and efficacy of a Ventralight ST echоpsimplant for a laparoscopic ventral hernia repair - a prospective cohort study with a one-year follow-up. Polski przeglad chirurgiczny. 2016;88(1):7-14.
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