Surgical treatment and prevention of paracolostomy hernia in patients of the elderly and senile age

Authors

  • V. O. Shaprynskyі M. Pyrohov Vinnytsia National Medical University
  • O. O. Vorovskyі M. Pyrohov Vinnytsia National Medical University
  • I. M. Sadyk M. Pyrohov Vinnytsia National Medical University

DOI:

https://doi.org/10.11603/2414-4533.2020.1.10744

Keywords:

paracolostomy hernia, hernioplasty, patients of elderly and senile age

Abstract

The аіm of the work: to improve results of surgical treatment of рaracolostomy hernias in patients of elderly and senile age on account of the introduction of laparoscopic methods of treatment.

Materials and Methods. Surgical treatment was performed by 3 methods: hernioplasty with colostomy left in the former place – 20 (29.0 %) patients; hernioplasty with the movement of colostomy on   new place – 36 (52.2 %); in 25 (36.2 %) – minimally invasive methods. 3 (4.3 %) patients were administered autoplastic; 66 (95.7 %) – alloplastic methods, where in the 4th (5.8 %) – by the onlay method, 40 (58.0 %) – by the sublay method, 17 (24.6 %) – laparoscopic hernioplasty by the advanced method and 8 (11.6 %) were laparoscopically assisted.

Results and Discussion. Among 69 patients, we found a direct proportional dependence of the intensity of the development of the connective process, not on the length of herniation, but on the size of the hernia gates. 24 patients underwent prophylactic use of prosthetic mesh when forming of stoma. Local pyo-inflammatory complications had a place in 6 (8.7 %) cases, where in 1 (1.4 %) patient with autoplastіс method hernioplasty and 5 (7.2 %) – when applying aloplastіс method.  No recurrence of the disease was observed. Elderly and senile patients when forming colostomy are advised preventive aloprosthetics. The best results were obtained with allohernioplasty with reconstruction of the colostomy to another location and with laparoscopic hernioplasty. 7 (10.1 %) patients with adhesiolysis of the distal and lowering of the proximal part of the gut were able to perform laparoscopically. 8 (11.6 %) patients with W3 defect performed laparoscopic allohernioplasty composite mesh by intraperitoneal IPOM technique.

References

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Published

2020-01-16

How to Cite

Shaprynskyі V. O., Vorovskyі O. O., & Sadyk, I. M. (2020). Surgical treatment and prevention of paracolostomy hernia in patients of the elderly and senile age. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (1), 80–85. https://doi.org/10.11603/2414-4533.2020.1.10744

Issue

No. 1 (2020)

Section

EXPERIENCE OF WORK

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