SURGICAL TREATMENT OF LUMBAR LATERAL POSTOPERATIVE ABDOMINAL HERNIA USING MODIFIED POLYPROPILENE MESH

Lutkovskyi R. A.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Aloplasty of lumbar lateral postoperative abdominal hernia (LLPAH), using modified polypropilene mesh, buth this is accompanied by a fairly high freguency of postoperative complications from the postoperative wound. In our view, the use of a nanomodified polypropylene mesh modified by carbon nanotubes and an antiseptic of polyhexamethleneguanidme chloride the results of operative treatment of LLPAH. Aim – to improve the results of surgical treatment of lumbar lateral postoperative abdominal hernia using modified polypropylene mesh. Object and methods. The analysis of surgical treatment of 184 patients with LLPAH of has been performed. Depending on the type of mesh used during surgical treatment, patients were divided into 2 groups. In 92 (50%) of Group I patients using modified polypropilene mesh. In the 2nd group, 92 (50%) patients using classic polypropylene mesh. Results and discussion. Statistically significant results were obtained in patients of Group I compared to Group II: seroma was in 26 (28.3±1.2%) in Group II compared to 6 (6.5±0.6%) in Group I (p<0.05), respectively, the suppuration of the postoperative wound – 12 (13.0±0.4%) to 2 (2.2±0.3%) (p<0.05). The terms of stay of patients of group II on inpatient treatment – 12,1±2,2 days, group II – 7,1±1,3 days. Long-term results: ligature fistulas of the anterior abdominal wall were detected in 4 (5.3±0.4%) patients of group II, in patients of group I of the ligature fistulas were not detected (p<0.05), meshoma – in 3 (3.9±0.2%) of patients in group II, in group I there was no stir (p>0.05). Chronic pain in the abdominal wall in 6-8 months after surgery was observed in 8 (10.5±0.5)% patients in group II and in 2 (2.6±0.3%) group I (p>0.05), recurrences of hernia were found in 8 (10.5±0.5%) patients of group II, in group I – in 1 (1.3±0.3)% (p<0.05). Conclusion. Surgical treatment of LLPAH using modified polypropilene mesh more effective compared with the use of the classical polypropylene mesh, namely, reducing the freguency of seroma from 28.3±1.2% in the II group of patients to 6.5±0.6% in group I, respectively, suppurations of postoperative wounds – from 13.0±0.4% to 2.2±0.3%, inflammatory infiltrates – from 14.1±0.4% to 2.2±0.3%, ligaturial fistulas of the abdominal wall – from 5.3±0.4% to 0%, meshoma – from 3.9±0.2% to 0%, chronic postoperative pain – from 10.5±0.5% to 2.6±0.3%, recurrence of hernia – from 10.5±0.5% to 1.3±0.3%

lumbar lateral postoperative abdominal hernia, modified polypropilene mesh, postoperative wound complications.

1. Feleshtynskiy JP. Pisljaoperaziyni grugi guvota. Kuiv: TOV «Bisnes-logika»; 2012. 200 s. [in Ukrainian].
2. Cheatham ML, White MW, Sagraves SG. Abdominal perfusion pressure: a superior parameter in the assessment of intra-abdominal hypertension J. Trauma. 2000;49(4):621-6.
3. Mischalov VG, Burca AO, Tesluc II. Chirurgichne licuvannja chvorich s pisljaoperazijnimi grugami poperecovo-bocovich diljanoc guvota. Chirurgia Ukraini. 2015;1(25):99-105. [in Ukrainian].
4. Millbourn D, Cengiz Y, Israelsson LA. Risk factors for wound complications in midline abdominal incisions related to the size of stitches. Hernia. 2011;15:261-6.
5. Mursabecjan JR, Dobrovolskij SR. Prognos i profilaktika ranevich oslognenij posle plastici perednej brjushnoj stenci po povodu posleoperacionnoj ventralnoj grugi. Chirurgija. 2008;1:66-71. [in Russian].
6. Sanders DL, Kingsnorth AN. From ancient to contemporary times: a concise history of incisional hernia repair. Hernia. 2011;16:1-7.
7. Lutkovskyi RA, Feleshtynskiy JP, Viltsanuk OA, Rezanova NM, vinachidniki. Vinnuckuj nazionalnuj medichnij universitet imeni M.I. Pirogova; patentovlasnik. Sposib aloplastiki pisljaoperazijnuch ventralnich grug s vikoristannjam nanomodifikovanoi polipropilenovoi sitku. Patent Ukrainu na korusnu model № 132818. 2019 Ver 11. [in Ukrainian].
8. Lutkovskyi RA. Morfologichnuj ta morfometrichnij analis smin v tkaninach pri implantazii sitchastich implantativ s polipropilenu modifikovanogo vuglezevumu nanotrubkamu ta antisepticom. Visnuk Vinnuckogo nazionalnogo medichnjgo universitetu. 2018 Trav;22(1):19-23. [in Ukrainian].
9. Lutkovskyi RA. Reakzija tkanun na polipropilenovi sitchasti implantatu. Visnuk morfologii. 2017 Trav;23(2):295-9. [in Ukrainian].

«Bulletin of problems biology and medicine» Issue 2 Part 1 (150), 2019 year, 156-159 pages, index UDK 616-007.43:617.55-089-06:538.5+615.28

10.29254/2077-4214-2019-2-1-150-156-159