OUTSTANDING ISSUES OF SURGICAL TREATMENT OF POSTOPERATIVE VENTRAL HERNIAS UNDER COMORBIDITY
DOI:
https://doi.org/10.11603/2415-8798.2017.1.7348Keywords:
post-surgical ventral hernia, comorbidity, non-differentiated dysplasia cytokines.Abstract
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.
References
Belokonev, V.I., Kovalyova, Z.V., & Vavilov, A.V. (2008). Kompleksnoye liecheniye bolnykh s posleoperatsionnoy ventralnoy hryzhey [Integrated treatment of patients with postoperative ventral hernia]. Khirurhiya – Surgery, 2, 42-47 [in Ukrainian].
Vynnyk, Yu.S., Petrushko, S.I., Nazaryants, Yu.A., Kochetova, L.V., Pakhomova, R.A., Kuznyetsov, M.N., … Markelova, N.M. (2013). Sovremennoye sostoianiye voprosa o metodakh hirurhicheskoho lyecheniya hryzh perednyei bryushnoy stenki [Modern status of the question of methods of surgical treatment of the herb of the front angle wall]. Sovremennyye problemy nauki i obrazovaniya – Modern Problems of Science and Education, 1 [in Russian].
Ivanov, S.V., Ivanov, I.S., Mamedov, R.A., Katunina, T.P., & Tsukanov, A.V. (2012). Dinamika profilya tsytokinov u bolnykh s posleoperatsionnymi hryzhami bryushnoy stenki pri protezirovanii s ispolzovaniyem politetraftoretilena i polivinilindenftorida [Dynamics of the profile of cytokines in patients with postoperative hernia of the abdominal wall with prosthetics using polytetrafluoroethylene and polyvinylidene fluoride]. Klin. khirurhiya – Clin. Surgery, 7, 37-41 [in Ukrainian].
Niechayeva, H.I. (Ed.) (2002). Displaziia soiedinitielnoi tkani [Dysplasia of connective tissue]. Omsk [in Russian].
Donskaya, Ye.D. (2008). Intraoperatsionnaya stvolovaya skleroobliteratsiya v khirurhicheskom liechenii varikoznoy bolezni [Intraoperative stem sclerobliteration in the surgical treatment of varicose veins]. Candidate’s thesis. Moscow [in Russian].
Todurov, I.M., Bilyanskyi. L.S., Perekhrestenko, O.V., Kosiukhno, O.V., Kalashnikov, S.V., & Plehutsa, O.I. (2010). Experymentalne doslidzhennia vplyvu faktora vnutrishniocherevnoho tysku na formuvannia poliorhannoi nedostatnosti ta bakterialnoi translokatsii [Experimental study of influence of abdominal pressure on the formation of multiple organ failure and bacterial translocation]. Klin. hirurhiia – Clin. Surgery, 6, 20-23 [in Ukrainian].
Zhebrovskyi, V.V. (2009). Khirurhiia hryzh zhyvota i inventratsii [Surgery of abdominal hernias and eventions]. Moscow: MIA [in Russian].
Ilchenko, F.M. (2007). Rekonstruktyvna khirurhiia pisliaoperatsiinykh hryzh cherevnoi stinky [Reconstructive surgery of industrial firewall mushrooms]. Extended abstract of Doctor’s thesis. Simferopol [in Ukrainian].
Elinov, N.P. (2000). Meditsynskaya mikologiya k XXI veku – v nachalye trietyego tysyachelyetiya [Medical mycology by the 21st century – at the beginning of the third millennium]. Problemy meditsinskoy mikologii – Problems of Medical Mycology, 4 (2), 6-12 [in Russian].
Kanikovskyi, O.Ye., & Omoboohundzhe, Dzh.O. (2008). Khirurhichne likuvannia pisliaoperatsiinykh ventralnykh hryzh [Surgical treatment of postoperative ventral hernias]. Biomedical and Biosocial Antropology, 8, 166-168 [in Ukrainian].
“Kruglyi stol” po problemam epidemiologii, kliniki i lyecheniya mikozov kozhy i yeyo prydatkov [“Round table” on epidemiology, clinic and treatment of skin mycoses and its appendages] (2001). Dermatolohiya ta venerolohiya – Dermatology and Venereology, 4 (14), 64-79 [in Ukrainian].
Kurygin, A.A., Sinenchenko, G.I., & Romashkin-Timanov, M.V. (2006). Bezretsydivnoye khirurgicheskoye lyecheniye poslyeoperatsionnykh ventralnykh gryzh kak sotsialnaya problema [Relapse-free surgical treatment of postoperative ventral hernias as a social problem]. Vestnik khirurgii im. I.I. Hrekova – I.I. Grekov Bulletin of Surgery, 9, 41-49 [in Russian].
Todurov, I.M., Bilianskyi, L.S., Kosiukhno, & S.V., Perekhrestenko, O.V. (2010). Likuvalna taktyka u khvorykh za naiavnosti hihanskykh defektiv cherevnoi stinky na tli morbidnoho ozhyrinnia [Therapeutic tactics in patients with the presence of giant abdominal wall defects on the background of morbid obesity]. Klin. hirurhiia – Clin. Surgery, 8, 35 [in Ukrainian].
Melnyk, I.V, Honchar, M.H., Pyptiuk, O.V (2009). Zastosuvannia polipropilenivoho endoproteza pry plastytsi zashchemlenykh ventralnykh hryzh [The use of polypropylene plastic implant at strangulated ventral hernia]. AML, XV (3), 35-36 [in Ukrainian].
Mylytsia, N.N., Toropov, Yu.D., & Mylytsia, K.N. (2009). Gryzha i gryzhevaya bolyezn: novyy vzglyad na patogenez zabolyevaniy [Hernia and hernial disease: a new look at the pathogenesis of diseases]. Klin. hirurhiia – Clin. Surgery, 1, 35-37 [in Ukrainian].
Mirzabekian, Yu.R., & Dobrovolskyi, S.R. ( 2008). Prognoz i profilaktika ranyevykh oslozhnieniy posle plastiki peredney bryushnoy stenki po povodu posleoperatsionnoy ventralnoy gryzhy [Prognosis and prophylaxis of wound complications after plasty of the anterior abdominal wall for postoperative ventral hernia]. Khirurhiia. Zhurnal im. N.I. Pirogova – Surgery. Journal by N.I. Pirogov, 1, 66-71 [in Russian].
Naumov, B.A., Chernookov, A.I., Shekhter, A.B., Tolibov, F.H., Aleksieievskykh, Yu.H., & Khalimdzhanov, Z.K. (2010). Morpholohicheskaya otsenka zazhyvleniya rany pri razlichnykh sposobakh plastiki defektov perednyey bryushnoy stenki u experimentalnykh zhyvotnykh i udalenyem gryzhy s proteziruyushchey rekonstruktivnoy plastikoy u bolnykh s ushchemlyonnymi posleoperatsionnymi ventralnymi gryzhami s ispolzovaniem fibrinovogo kleya [Morphological evaluation of wound healing with various methods of plastic repair of anterior abdominal wall defects in experimental animals and removal of a hernia with prosthetic reconstructive plasty in patients with impaired postoperative ventral hernia using fibrin glue]. Annaly khirurgii – Annals of Surgery, 4, 37-45 [in Russian].
Yermolov, A.S., Blagovestnov, D.A., Upyryov, A.V., & Illichyov, V.A. (2009). Obshchiye printsypy khirurgicheskogo lyecheniya ushchemlyonnykh gryzh bryushnoy styenki [General principles of surgical treatment of strangulated abdominal hernias]. Meditsynskiy almanakh – Medical Almanac, 3 (8), 23-27 [in Russian].
Dyesyatnikova, I.B., Sidorov, M.A., Medvedyev, A.P., Berezova, L.Ye. (2009). Opyt primyenyeniya polipropilenovogo endoproteza pri plastike perednyei bryushnoy stenki v usloviyah infitsirovaniya [Experience in the use of a polypropylene endoprosthesis in the plasty of the anterior abdominal wall in conditions of infection]. Meditsynskiy almanakh – Medical Almanac, 2, 170-172 [in Russian].
Yevsyeyev, M.A., Golovin, R.A., Sotnikov, D.N., Lazarecheva, N.M. (2011). Osobennosti khirurgicheskoy taktiki pri posleoperatsionnykh ventralnykh gryzhakh u patsiyentov pozhylogo i starcheskogo vozrasta [Features of surgical tactics in postoperative ventral hernias in elderly and senile patients]. Vestnik experimentalnoi i klinicheskoy khirurgii – Bulletin of Experimental and Clinical Surgery, 1 (4), 10-16 [in Russian].
Plyeshkov, V.G., & Agafonov, O.I. (2009). Posleoperatsionnyye ventralnyye gryzhy – nyereshonnyye problyemy [Postoperative ventral hernia – unsolved problems]. Vestnik experimentalnoy i klinicheskoy khirurgii – Bulletin of Experimental and Clinical Surgery, 3 (2), 247–254 [in Russian].
Podyorgin, A.V., & Halzov, V.L. (2006). Nyeudachi gryzhesyecheniy s plastikoy polipropilenovoy syetkoy [Failures of hernia with polypropylene mesh]. Vyestnik gerniologii – Herald of Herniology, 2, 149–152 [in Russian].
Todurov, I.M., Bilyanskyi, L.S., Lysun, Yu.B., Perekhrestenko, A.V., & Kosiukhno, S.V. (2010). Sovremennyye podhody k resheniyu problemy rekonstruktivno-vosstanovitenoy khirurgii obshyrnykh defektov bryushnoy styenki [Modern approaches to solving the problem of reconstructive-restorative surgery of extensive abdominal wall defects]. Materialy nauk. Konhr. «IV Mizhnarodni Pyrohovski chytannia», ХХІІ zizd khirurhiv Ukrainy – Materials Sciences. Congré.: «IV International Pirogov reading», XXII Congress of Surgeons of Ukraine, (1), 25 [in Ukrainian].
Tomnyuk, N.D, Ryabov, I.A., & Chernukh, A.N. (2009). Analiz prichin neudovletvoritelnykh rezultatov khirurgicheskogo lyecheniya ushchemlyonnykh gryzh I puti ikh uluchsheniya [Analysis of the causes of unsatisfactory results of surgical treatment of strangulated hernias and ways to improve them]. Sovremennyye problemy nauki i obrazovaniya – Modern Problems of Science and Education, 6, 88-90 [in Russian].
Verkhulyetskiy, I.Ye., Papazov, F.K., & Medvedenko, A.F. (2011). Trudnosti v diagnostike i lyechenii ushchemlyonnykh posleoperatsionnykh ventralnykh gryzh [Difficulties in the diagnosis and treatment of strangulated postoperative ventral hernias]. Ukrainskyi zhurnal khirurhii – Ukrainian Journal of Surgery, 6 (15), 129-133 [in Ukrainian].
Fathudinov, I.M., & Krasilnikov, D.M. (2008). Vybor sposoba gernioplastiki u bolnykh s ushchemlyonnymi obshyrnymi i gigantskimi posleoperatsionnymi gryzhami [The choice of the method of hernioplasty in patients with impaired extensive and giant postoperative hernias]. Sovremennyye problemy nauki i obrazovaniya – Modern Problems of Science and Education, 2, 41-43 [in Russian].
Fedorov, I.V., Slavin, L.Ye, & Kochnyev, A.V. (2006). Seroma kak oslozhnyeniye gryzh zhyvota [Seroma as a complication of abdominal hernia surgery]. Vestnik gerniologii – Journal of Herniology, 2, 195-198 [in Russian].
Felyeshtynskyi, Ya.P., Vatamaniuk, V.F., Svyrydovskyi, S.A. & Dubenets, V.O. (2009). Explantatsiia sitok pry uskladnenniakh alohernioplastyky, pokazannia ta prophilaktyka [Explantation of nets at alohernioplasty complications, indications and prevention]. Lvivskyi medychnyi chasopys – Lviv Medical Journal, 2, (15), 61-64 [in Ukrainian].
Felyeshtynsky, Ya.P., Mamchych, V.I., Vatamaniuk, V.F., & Dubenets, V.O. (2010). Varianty aloplastyky hihantskykh pisliaoperetsiinykh ventralnykh hryzh ta prophilaktyka abdominalnoho kompartment syndromu [Options of aloplasty of giant postoperative ventral hernias and prevention of abdominal compartment syndrome]. Materialy naukovoho konhresu «IV mizhnarodni Pyrohovski chytannia» prysviacheni 200-richchiu z dnia narodzhennia M.I. Pyrohova, ХХІІ zizd khirurhiv Ukrainy – Materials of Science Congress «IV International Pyrohov reading», dedicated to the 200-th anniversary of M.I. Pyrohov. (pp. 194-195). Vinnytsia [in Ukrainian].
Felyeshtynskyi, Ya.P., & Dubenets, V.O. (2006). Optymizatsiia profilaktyky uskladnen zahoiennia rany pry khirurhichnomu likuvanni velykykh ta veletenskykh pisliaoperatsiinykh hryzh cherevnoi stinky [Optimization of prevention of complications of wound healing in surgical treatment of large and giant postoperative hernias of the abdominal wall]. Klin. khirurhiia – Clin. Syrgery, 11-12, 43-43 [in Ukrainian].
Tsvyetkov, V.O. (2003). Hnoynyye oslozhneniya gernioplastiki s ispolzovaniyem setchatykh endoprotezov. Sovremennyye metody hernioplastiki abdominoplastiki s primyenyeniyem polimernukh implantov: 1-ya mezhdunarodnaya konferentsiya Purulent complications of hernioplasty using reticular endoprostheses – The First International Conference Modern methods of hernioplasty abdominoplasty with the use of polymeric implants. (pp.77-78). Moscow [in Russian].
Shvachko, S.A. (2008). Ispolzovaniye polipropilenovykh explantov v neotlozhnoy khirurgii gryzh bryushnoy styenki [Use of polypropylene explants in emergency surgery of abdominal hernia]. Extended abstract of Candidate’s thesis. Moscow [in Russian].
Teng, Y.J., Pan S.M., Liu, Y.L., Yang, K.H, Zhang, Y.C, Tian, J.H, & Han J.X. (2011). A meta-analysis of randomized controlled trials of fixation versus nonfixation of mesh in laparoscopic total extraperitoneal inguinal hernia repair. Surg. Endosc., 25 (9), 2849-2858 [in Russian].
Bansal, V.K., Misra, M.C., & Kumar, S.A. (2011). Prospective randomized study comparing suture mesh fixation versus tacker mesh fixation for laparoscopic repair of incisional and ventral 184 hernias. Surg. Endosc., 5 (25), 1431-1438 [in Russian].
Burger, J., Luijendijk, R., & Hop W. (2004). Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann. Surg., 4 (240), 578-583 [in Russian].
Hurwitz, Z.M., Brien, J.O., & Dunn, R.M. (2011). Pearls and pitfalls of an abdominal wall anatomy in component separation. Hernia, 15 (2), 3.
Breuing, K., Butler, C.E., Ferzoco, S., Franz, M., Hultman, C.S., & Kilbridge, J.F. (2010). Incisional ventral hernias: review of the literature and recommendations regarding the grading and technique of repair. Surgery, 3 (148), 544-558; doi: 10.1016/j.surg.2010.01.008. Surgery.
Itani, K.M., Hur, K. F., Kim, L.T., Anthony, T, Berger, D.H., Reda, D., & Neumayer, L. (2010). Comparison of laparoscopic and open repair with tpsh for the treatment of ventral in Retrieved from: cisional hernia: a randomzed trial. Arch. Surg, 4 (145), 322–328 [in Russian].
Kingnorth, A. (2006). The management of incisional hernia. Ann. R. Coll. Surg. Engl. 88, 252-260 [in Russian].
Martinez-Serrano, M.A., Pereira, J.A., Sancho, J.J., Lopez-Cano, M., Bombuy, E., & Hidalgo, J. (2009). Risk of death after emergency repair of abdominal wall hernias. Still waiting for improvement. Langenbecks. Arch Surg, 10 [in Russian].
Matyja, A., Solecki, R., Heitzman, J. (2004.) Local reaction to polypropylene mesh – histopatological findings. Hernia Recurrences.
Misiakos, E.P., Machairas, A., Patapis, P., Liakakos, T., Misiakos, E.P., Machairas, A. … & Patapis, P. (2008). Laparoscopic Ventral Hernia Repair: Pros and Cons Compared With Open Hernia Repair. JSLS, 12, 117-125 [in Russian].
Munoz, P., Burillo, A., Bouza, E. (2002). Criteria used when initiating antifungal therapy against Candida spp. in the Intensive Care Unit. International Journal of Antimicrobial Agents, 15, 83-90 [in Russian].
Newman, M.I. (2009). Reducing the incidence of recurrence in component
separation repair. General. Surg. News, 9 [in Russian].
Offner F.A. (Eds.) Schumpelick, V., & Nyhus, L.M. (2004). Pathophysiology and pathology of the foreign body reaction to mesh implants in Meshes: Benefits and Risks. Berlin: Springer.
Raghavendra, S., Raghavendra, P., Gentileschi, S., & Kini, S. (2011). Management of ventral hernias in bariatric surgery. Surg. Obes. Relat. Dis. 7, 110-116.
Downloads
Published
How to Cite
Issue
Section
License
Authors who sent their manuscript to "Вісник наукових досліджень. Bulletin of Scientific Research" Surgery agree to the following terms:
a. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal. 
b. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
c. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
