RESUMO
The authors analyze the results of experimental and clinical investigations for comparative studying a new meshed implant of polyvinylidene fluoride as an endoprosthesis of the anterior abdominal wall with postoperative hernias. It was shown that the polyvinylidene fluoride prosthesis is a good alternative of polypropylene prosthesis. Its physico-chemical properties allow reliable prostheses of the abdominal wall, and its biological compatibility is higher as compared with polypropylene prosthesis.
Assuntos
Hérnia Abdominal/cirurgia , Polivinil , Implantação de Prótese/instrumentação , Telas Cirúrgicas , Animais , Modelos Animais de Doenças , Feminino , Seguimentos , Humanos , Masculino , Membranas Artificiais , Pessoa de Meia-Idade , Desenho de Prótese , Ratos , Ratos Wistar , Estudos Retrospectivos , Resultado do TratamentoRESUMO
A new method of operative treatment of postoperative ventral hernias is proposed which provides reliable fixation of the implant along the whole line of the primary scar. It excludes its migration due to profound integration into all layers of the abdominal wall and reliable fixation at different levels and with sufficient distance from the hernia hilus. The method can be used for any size of the hernia hilus. This method of plasty of the anterior abdominal wall is especially indicated for great, inreducible hernias, for great defects of the abdominal wall and incarcerated postoperative hernias when continuous preoperative preparation is impossible. Long-term results of the operative treatment were analyzed in terms from 1 year to 3 years in 16 patients aged from 40 to 73 years of age (mean age 58+/-2.6 years) with great and giant postoperative hernias. No recurrences were noted.
Assuntos
Materiais Biocompatíveis , Hérnia Ventral/cirurgia , Polipropilenos , Implantação de Prótese/instrumentação , Telas Cirúrgicas , Adulto , Idoso , Feminino , Seguimentos , Hérnia Ventral/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos , Fatores de TempoRESUMO
During 20 years 356 patients with morbid obesity of the III-IV degrees were operated on, 339 of them being subjected to jejunoileal shunting in the authors' modification. The developed measures for the selection of patients, preoperative preparation, anesthesia and operation technique allowed the amount of postoperative complications to be reduced from 15 to 5%. Long-term results were followed-up in 220 patients during 3-17 years. Stable loss of the body mass, regression of the diseases resulting from obesity were noted in 187 of these patients (85%). Electrolytic disorders were found in 16.8% of the patients. The reconstruction of the small intestine because of progressing hepatic insufficiency was performed in 16 patients. Less than 20% loss of the body mass was noted in 18 patients.
Assuntos
Obesidade Mórbida/cirurgia , Adulto , Anestesia Geral , Feminino , Seguimentos , Derivação Gástrica/métodos , Gastroplastia/métodos , Humanos , Masculino , Erros Médicos , Pessoa de Meia-Idade , Obesidade Mórbida/complicações , Seleção de Pacientes , Cuidados Pré-OperatóriosRESUMO
The authors make an analysis of their experiences with combined operations for extreme forms of obesity in 93 patients. Indications to such operations were considered to be only the diseases which could cause complications of the early and late postoperative period. In spite of more pronounced signs of aggression the combined operations do not enhance frequency and severity of postoperative complications. Recommendations are given for the selection of anesthesia, the access and sequence of operation steps. Measures are proposed which allow the frequency of postoperative complications to be decreased from 59.8 to 29.8%.
