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Khirurgii

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Year 2013 Vol. 21 No 2

GENERAL AND SPECIAL SURGERY

L.K.KULIKOV1,Î.À.BUSLAEV2,S.V.SHALASHOV2,À.À.SMIRNOV1,A.L.MIKHAYLOV2,I.A.EGOROV3,L.P.SHADAROV2,S.T.SOBOLEV2,V.F.SOBOTOVICH1,U.A.PRIVAL

SURGICAL TREATMENT OF EXTENSIVE AND GIANT VENTRAL INCISIONAL HERNIAS

SBEE APE “Irkutsk State Medical Academy of Post-Graduate Education”1,
NGHA “Railway Clinical Hospital at the station Irkutsk - Passenger” of JSC “Russian Railways”2,
The Russian Federation

Objectives. To evaluate effectiveness of surgical treatment of extensive and giant incisional hernias with the developed method of “the cut mesh prosthesis”.
Methods. Prospective investigation including 48 patients was conducted. Two groups were allocated. 27 patients who were subjected to plasty using the designed “the cut mesh prosthesis” method made up the main group (MG); 21 patients who underwent Shumpelik’s surgery made up the group of clinical comparison (GCC). The designed method differs from the existed ones in the way of endoprosthesis fixation in the tissues. Endoprosthesis is not sewed to the tissues but fixed by means of strips cut to its edges. Multislice computed tomography (MSCT) with hernioabdomenometry and surface electromyography (EMG) were carried out before and after the intervention. The number and character of complications were evaluated in the early postoperative period. Recurrences and life quality were analyzed in long-term period.
Results. Out of 27 main group patients early postoperative complications were revealed in 4 (14,8%) and in the group of clinical comparison (n=21) the complications developed in 6 (28,6%) of patients. At electromyography of the straight abdominal muscles in patients the electropotentials were irregular and low amplitude in both main and clinical comparison groups before the operation. One year after operation more significant restoration of the biopotentials of straight muscles was observed. No recurrences were revealed in the main group in the long-term period up to five years. Two hernia recurrences were revealed in the group of clinical comparison. While evaluating the life quality in the main group patients an increase of physical and psychological components of health was registered in contrast to the comparative group (ð<0,01).
Conclusions. The designed method of “the cut mesh prosthesis” increases effectiveness of patients’ treatment with extensive and giant incisional hernias by reducing of recurrences and reliable improvement of patients’ life quality.

Keywords: incisional ventral hernia, prosthesis plasty, hernioplasty methods
p. 37 – 44 of the original issue
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Address for correspondence:
664079, Rossiiskaia Federatsiia, g. Irkutsk, m-n. Iubileinyi 100, GBOU DPO «Irkutskaia gosudarstvennaia meditsinskaia akademiia poslediplomnogo obrazovaniia», kafedra khirurgii,
e-mail: giuv.surgery@ya.ru,
Kulikov Leonid Konstantinovich
Information about the authors:
Kulikov L.M. MD, professor, a head of the surgery chair of SBEE APE “Irkutsk State Medical Academy of Post-Graduate Education”.
Buslaev O.A. A head of the surgical department of NGHA “Railway clinical hospital at the station Irkutsk-Passenger ” of JSC “Russian Railways”.
Shalashov S.V. PhD, a surgeon of the surgical department of NGHA “Railway clinical hospital at the station Irkutsk-Passenger” of JSC “Russian Railways”.
Smirnov A.A. PhD, an assistant of the surgery chair of SBEE APE “Irkutsk State Medical Academy of Post-Graduate Education”. Mikhaylov A.L. A surgeon of the surgical department of NGHA “Railway clinical hospital at the station Irkutsk-Passenger ” of JSC “Russian Railways”.
Egorov I.A. A surgeon of the surgical department of NGHA “Railway clinical hospital at the station Irkutsk- Passenger” of JSC “Russian Railways”.
Shadarov l.P. A physician of the functional diagnostics department of NGHA “Railway clinical hospital at the station Irkutsk-Passenger” of JSC “Russian Railways”.
Sobolev S.T. PhD, a physician of the functional diagnostics department of NGHA “Railway clinical hospital at the station Irkutsk- Passenger” of JSC “Russian Railways”.
Sobotovich V.F. PhD, associate professor of the surgery chair of SBEE APE “Irkutsk State Medical Academy of Post-Graduate Education”.
Privalov U.A. PhD, associate professor of the surgery chair of SBEE APE “Irkutsk State Medical Academy of Post-Graduate Education”.
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