OUTSTANDING ISSUES OF SURGICAL TREATMENT OF POSTOPERATIVE VENTRAL HERNIAS UNDER COMORBIDITY

• Main Author: V. I. Piatnochka
• Format: Article
• Language: Ukrainian
• Published: Ukrmedknyha Publishing House 2017-04-01
• Series: Vіsnik Naukovih Doslіdžen'
• Subjects: післяопераційна вентральна грижа; коморбідність, недиференційована дисплазія; цитокіни; ускладнення.
• Online Access: https://ojs.tdmu.edu.ua/index.php/visnyk-nauk-dos/article/view/7348
• ISSN: 1681-276X; 2415-8798

Surgical treatment of patients with ventral hernia is one of the important issues of abdominal organs surgery. The aim of the study – based on the analysis of literature data, to identify the main priority areas that require further study and development in the surgical treatment of patients with postoperative ventral hernia in conditions of comorbidity. Materials and metods. A review of literature sources devoted to the study of the surgical treatment of patients with postoperative ventral hernias under conditions of comorbidity was conducted. Results and discussion. From 3 % to 19 % of all laparotomies are complicated by the formation of POGH with a tendency to increase. 60 % of patients with a working age POGH, which determines the problem of treating such patients not only as a medical one, but also as a social one. The percentage of relapses is 4.3–46 %, and for large and giant POGH it reaches 80 % with a mortality rate of 12–21 %, in patients of the older age group. In patients with morbid obesity, the risk of POGH both after laparotomy and after laparoscopic surgery increases 3–4 times and is 28–45 %. The experience of the active use of nets in surgery POGH demonstrated the significant advantages of polypropylene monofilament materials, and their comparative evaluation in the literature is quite restrained. The analysis of the literature emphasizes that the result of surgical treatment of postoperative ventral hernias depends, both on local factors in the implantation zone of the mesh endoprosthesis, and on the general state of the organism. Conclusions. The problem of increased fluid exudation in the area of implantation of the mesh remains unsolved, there is no comparative evaluation of the tissue response to grids with a different specific gravity of the content of the silt and the pore diameter. There are no criteria for selecting the implant and the method of surgical intervention in patients with NDT. The possibilities of ultrasound monitoring for the purpose of assessing the state of tissues in the area of implantation of the mesh in the postoperative period are not sufficiently elucidated. All this is subject to further scientific study.