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Criteria for choosing surgical treatment of patients with ventral hernias and obesity
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| Author:
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, DIYOR SH.ABDURAXMANOV, ZAFAR B.KURBANIYAZOV, SALIM S. DAVLATOV, KOSIM E.RAKHMANOV
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| Abstract:
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Rationale. Simultaneous surgeries are a promising area of modern herniology. In regards to this the development of objective indications and contraindications for performing simultaneous interventions on the organs of the abdominal cavity and abdominal wall in patients with ventral hernia is extremely important and affects the approaches of the proposed surgery method and the technique of its execution. Objective. Improving the results of surgical treatment of patients with ventral hernias with concomitant obesity by improving surgical tactics. Materials. The work is based on the analysis of the results of surgical treatment of 164 obese patients with ventral hernias. All surgeries were performed in the surgical department of the First clinic of the Samarkand State Medical Institute in the period from 2009 to 2016. The patients were divided into two groups: the control group (72-43.9%) and the main group (92-56. 1%). According to indications, patients of the control group underwent classical hernioplastic surgery with local tissues and prosthetic materials. In the main group patients underwent hernia repair using mesh implants with the addition of dermatolipectomy. Results. To assess the effectiveness of the results of treatment of patients in the discussed groups, the following comparison parameters were used as the main criteria: - abdominal complications of the early postoperative period; - extra - abdominal complications of the early postoperative period; - wound complications in the early postoperative period; - long-term results of surgical treatment. Conclusion. According to Ramirez, the optimal type of hernioplastic surgery in patients with III – IV grade obesity is a combination of abdominoplastic surgery, supplemented by the mobilization of the rectus abdominis muscles. The reliability of the hernia gate plastic is ensured by a polypropylene prosthesis, and the mobilization of the rectus muscles ensures the preservation of intra-abdominal pressure at the initial values. Prosthetic hernia repair in combination with dermatolipectomy improves the quality of life of such patients in all parameters. The aesthetic component of the surgery contributes to the appearance of motivation to reduce body weight.
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| Keyword:
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ventral hernias, obesity, hernioplastic surgery, polypropylene prosthesis, dermatolipidectomy, abdominoplastic surgery.
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2021.13.01.598
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