RESUMO
OBJECTIVE: The purpose of the study was to evaluate the results of using fluoropolymer-coated mesh during intraperitoneal onlay mesh hernia repair in patients with primary ventral hernias. MATERIAL AND METHODS: The multicenter, non-randomized, controlled clinical study included 88 patients of both sexes who were operated on using a laparoscopic approach using the IPOM technique for a primary ventral hernia. The duration of observation ranged from 3 to 12 months. In the main group, 48 patients received fluoropolymer-coated meshes (Ftorex). A comparison was made with a retrospective group of 40 patients who were treated with anti-adhesive collagen-coated meshes (Parietene composite, Parietex Composite, Symbotex). RESULTS: The number of early and late postoperative complications in the groups did not have significant differences, at the same time, their number was lower in the group of patients in whom fluoropolymer-coated meshes were used. Most of the complications corresponded to Clavien-Dindo class I and II and did not pose a significant threat to health. There were no recurrences of hernias observed in patients included in the study. There were slightly more adhesions in the fluoropolymer-coated mesh group (35.4% vs. 25.0% in the collagen-coated mesh group). The quality of life of patients in the study groups did not differ. CONCLUSION: In laparoscopic IPOM hernia repair fluoropolymer-coated meshes are not inferior in effectiveness and safety to traditionally used collagen-coated meshes and can be recommended for use in patients with primary ventral hernias.
Assuntos
Hérnia Ventral , Herniorrafia , Laparoscopia , Complicações Pós-Operatórias , Telas Cirúrgicas , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Materiais Revestidos Biocompatíveis , Polímeros de Fluorcarboneto , Hérnia Ventral/cirurgia , Herniorrafia/métodos , Herniorrafia/efeitos adversos , Herniorrafia/instrumentação , Laparoscopia/métodos , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Federação Russa , Aderências Teciduais/prevenção & controle , Resultado do TratamentoRESUMO
An experience with treatment of diffuse purulent peritonitis for acute diseases of organs of the abdominal cavity is described. An analysis of examinations and treatment of 130 patients with diffuse purulent peritonitis was made in groups of patients where the method of laparostomy with programmed sanitations of the abdominal cavity and the methods of laparoscopy and traditional treatment were used. The method of laparostomy with programmed sanitations of the abdominal cavity in patients with toxic and terminal phases of diffuse purulent peritonitis is an effective method of treatment resulting in less frequency of postoperative complications and lethality of patients with this pathology.
Assuntos
Drenagem/métodos , Laparoscopia/métodos , Laparotomia/métodos , Peritonite/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Federação Russa/epidemiologia , Taxa de Sobrevida/tendências , Técnicas de Sutura , Resultado do Tratamento , Adulto JovemRESUMO
Treatment of 92 patients aged from 18 to 69 years with abscesses and phlegmons of soft tissues included programmed irrigation and drainage. Apparatuses with two-level programs were used. It was shown that programmed irrigation and drainage allowed microbial dissemination by wash liquid to be decreased to 10 colony-forming units per 1 ml during 3 days. This term can be shortened to 1 day when using the program of intensive irrigation and drainage (more than 200 cycles during the first days after operation) and when intraoperative treatment with a beating jet of liquid is used in combination with curettage and vacuuming.