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Year 2012 Vol. 20 No 5
GENERAL AND SPECIAL SURGERY
CHOICE OF HERNIOPLASTY METHOD AND ALGORITHM OF POSTOPERATIVE TREATMENT OF PATIENTS WITH VENTRAL HERNIAS
State Budgetary Educational Establishment of Higher Professional Education “Smolensk State Medical Academy”
The Russian Federation
Objectives. To improve the treatment results of patients with ventral hernias by individualization of treatment tactics on the basis of ultrasonic investigation of the structure and blood supply specialties of the anterior abdominal wall.
Methods. The research included 107 subjects, who have been operated on (planned hernioplasty with polypropylene mesh). The operated were divided into two groups. The main group enumerated 50 patients, the control one – 57. Treatment tactics of the control group patients was conventional. Ultrasonic tomography of the abdominal wall was carried out additionally in the main group of patients in the preoperative period; its results were used to individualize the operative intervention choice. In the postoperative period ultrasonic monitoring of the postoperative wound was used. The results of surgical treatment in the main and control groups were assessed at the early postoperative period; the character of postoperative course was analyzed as well as the number of complications.
Results. Postoperative complications in the main group developed in 5 (10%) subjects: seroma formation – in 3 (6%) cases, postoperative wound infiltration – in 2 (4%) cases. Postoperative complications in the control group were revealed in 8 (14,04%) subjects. Postoperative wound infection was revealed in 1 (1,75%) case, fistula formation – 1 (1,75%) case, seroma formation – 5 (8,8%) subjects, postoperative wound infiltration – in 3 (5,3%) cases.
In 8 (16%) observations in the main group according to ultrasound investigation we managed to reveal timely the pathological changes in the transplant zone; it permitted to foresee possibility of development of local complications and to perform effective conservative procedures.
Conclusions. The research has proved the efficacy of usage of ultrasonography in diagnostic and treatment of patients with ventral hernias. Ultrasonic methods permit to individualize the choice of hernioplasty method, to objectify the control of the wound process course, to foresee development of complications in the postoperative wound and to perform their timely correction.
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214001, Rossiyskaya Federatsiya, g. Smolensk, ul. Frunze, d. 40, GBOU VPO «Smolenskaya gosudarstvennaya meditsinskaya akademiya» kafedra fakultetskoy khirurgii,
Markova Yana Anatolevna
Markova A.A. intramural post-graduate student of the faculty surgery chair of SBEE HPE “Smolensk state medical academy”.