RESUMO
Complex examination and treatment of 120 patients with anatomo-functional insufficiency of the abdominal wall was made after operations on organs of the abdominal cavity and retroperitoneal space. In the 1st group (60 patients) the abdominal wall was sutured by traditional methods. In the 2nd group (60 patients) laparotomy was followed by implantation of polypropylene endoprosthesis by over-aponeurotic method, and suturing of the lateral wall--by sub-aponeurotic method. At the long-term postoperative period the postoperative ventral hernias were formed in 21.6% of patients of the 1st group, in the 2nd group of patients hernias were not detected. Physical component of quality of life of the 2nd group was 1.5 times, and mental component 1.7 times higher than in the 1st group.
Assuntos
Parede Abdominal , Hérnia Ventral , Laparotomia/efeitos adversos , Polipropilenos/uso terapêutico , Complicações Pós-Operatórias/prevenção & controle , Próteses e Implantes , Cavidade Abdominal/cirurgia , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/fisiopatologia , Parede Abdominal/cirurgia , Adulto , Feminino , Hérnia Ventral/etiologia , Hérnia Ventral/fisiopatologia , Hérnia Ventral/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/fisiopatologia , Período Pós-Operatório , Ajuste de Prótese , Retenção da Prótese , Qualidade de Vida , Espaço Retroperitoneal/cirurgia , Resultado do Tratamento , Ultrassonografia , Técnicas de Fechamento de FerimentosRESUMO
An analysis of complex examination and treatment of 151 patients after planned and performed surgical interventions on organs of the retroperitoneal space was made. The patients were divided into 4 groups. The first group (of comparison) included 46 patients who were treated by lumbotomy for different diseases of organs of the urinary system. In 35 patients of the second group (prophylactics) the indications were determined and in 20 patients preventive endoprosthesis of the lateral abdominal wall using polypropylene endoprosthesis was fulfilled. Herniotomy with plasty of the lateral abdominal wall using local tissues was fulfilled in 30 patients. Prosthesing hernioplasty of the lateral abdominal wall was fulfilled in 40 patients of the main group. It was found that preventive endoprosthesis of the lateral abdominal wall allowed prevention of progressing anatomo-functional i/isufficiency and the appearance of postoperative hernias. The application of polypropylene endoprosthesis for the treatment of postoperative hernias allows obtaining 36.4% more good results as compared with the control group, 21.7% decreased number of satisfactory results and no recurrent hernias.
Assuntos
Músculos Abdominais/cirurgia , Parede Abdominal/cirurgia , Hérnia/prevenção & controle , Polipropilenos/uso terapêutico , Espaço Retroperitoneal/cirurgia , Deiscência da Ferida Operatória/cirurgia , Músculos Abdominais/patologia , Músculos Abdominais/fisiopatologia , Parede Abdominal/patologia , Parede Abdominal/fisiopatologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Materiais Biocompatíveis/uso terapêutico , Feminino , Hérnia/etiologia , Hérnia/patologia , Hérnia/fisiopatologia , Humanos , Região Lombossacral/patologia , Região Lombossacral/fisiopatologia , Região Lombossacral/cirurgia , Masculino , Teste de Materiais , Pessoa de Meia-Idade , Implantação de Prótese/instrumentação , Implantação de Prótese/métodos , Prevenção Secundária , Perfil de Impacto da Doença , Telas Cirúrgicas/normas , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Deiscência da Ferida Operatória/patologia , Deiscência da Ferida Operatória/fisiopatologia , Resultado do TratamentoRESUMO
120 patients with abdominal wall anatomic-functional insufficiency were examined and treated. All patients were divided in 2 similar groups 60 patients each. Patients of the first group had traditional laparotomy wound closure, whereas patients of the second group overcame polypropylene mesh implantation. 21.6% of patients from the first group revealed postoperative ventral hernias at follow-up, none of the second group faced such a problem. Physical component of the quality of live was 3.2 times, and psychological component - 2,6 times higher in patients of the second group.
Assuntos
Cavidade Abdominal/cirurgia , Músculos Abdominais/diagnóstico por imagem , Hérnia Ventral/etiologia , Contração Muscular/fisiologia , Qualidade de Vida , Espaço Retroperitoneal/cirurgia , Deiscência da Ferida Operatória/cirurgia , Músculos Abdominais/fisiopatologia , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/fisiopatologia , Adulto , Idoso , Feminino , Seguimentos , Hérnia Ventral/patologia , Hérnia Ventral/cirurgia , Humanos , Laparotomia/métodos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Retrospectivos , Telas Cirúrgicas , Deiscência da Ferida Operatória/complicações , Deiscência da Ferida Operatória/patologia , Resultado do Tratamento , Ultrassonografia , Adulto JovemRESUMO
Results of clinical examination of abdominal cavity at 450 patients with various abdominal surgical diseases are analyzed. Special scale has been developed for risk assessment of postoperative hernia, identification of absolute and relative indications for abdominal endografting. Overall 47 patients according to absolute indications underwent preventive plastic surgery with polypropylene endograft during abdominal operations. There were no cases of postoperative hernia during 1-3 years of follow-up.