COMBINED SURGERIES AS A METHOD FOR TREATMENT INTENSIFICATION IN PATIENTS WITH POSTSURGICAL VENTRAL HERNIA AND PERITONEAL COMMISSURES OF ABDOMINAL CAVITY

Abstract

Aim. To improve the results of surgical treatment in patients with postsurgical ventral hernia, combined with peritoneal commissure of abdominal cavity is considered. Materials and methods. 79 patients aged 30-80 with ventral hernias, men/women parity 24:88 were examined. According to Toskin-Zhebrovsky classification hernias of the small sizes were observed in 16 (20,3%) patients, hernias of the average sizes – in 23 (29,1%) patients, hernias of the extensive sizes – in 27 (34,2%) patients and huge in the rest 13 (16,4%) patients. According to SWR-classification hernias of median localization were observed in 59 (74,7%) patients, lateral localization – in 12 (15,2%) patients, combined localizations – in 8 (10,1%) patients. According to the width of hernia gate: W1 – in 16 (20,3%) patients, W2 – in 23 (29,1%) patients, W3 – in 27 (34,2%) patients, W4 – in 13 (16,4%) patients. All patients undergone surgeries. The open surgeries including simultaneous stages were performed in 57 patients with postsurgical ventral hernias (PVH). Closed hernioplasty was performed in 22 patients. Results. At opened hernioplasty early complications were observed in 14 (24,5%) patients: in 1 patient (7,2%) it was a wound suppuration; in 10 (71,4%) patients – seromas; in 3 (21,4%) patients – early postsurgical intestinal obstruction. All patients who undergone closed video assisted surgeries have recovered. It was found, that in case of comorbidities the surgery is performed on the burdened background. Conclusion. It seems critically important to improve the immediate results of surgical treatment of patients with postsurgical ventral hernia and peritoneal commissures of the abdominal cavity by optimizing operational tactics and managing patients in the postoperative period.