[Preventive abdominal wall reconstruction in patients with risk factors of eventration undergoing emergency abdominal surgery]. / Preventivnoe endoprotezirovanie bryushnoi stenki u ekstrennykh bol'nykh s riskom razvitiya eventratsii.

OBJECTIVE: To prevent eventration via preventive abdominal wall reconstruction in patients with risk factors of eventration undergoing emergency abdominal surgery. MATERIAL AND METHODS: Treatment results in 120 patients with risk factors of eventration undergoing emergency abdominal surgery were retrospectively analyzed. Patients were divided into 2 groups by 60 people. In the first group, traditional layer-by-layer suturing of the abdominal wall was performed. Preventive abdominal wall reconstruction with a standard polypropylene prosthesis was applied in the second group. We assessed postoperative complications and mortality. RESULTS: The following risk factors of eventration were detected: elderly and senile age (82.5%), long laparotomy (72.5%), decompensated comorbidities (62.5%), widespread peritonitis (52.5%), intestinal obstruction (42.5%), severe internal bleeding (12.5%), disseminated cancer (12.5%), obesity grade 3-4 (10%). In the first group, postoperative morbidity and mortality were 61.7% (n=37) and 13.3%, in the second group - 25% (n=15) and 8.3%, respectively. CONCLUSION: Preventive abdominal wall reconstruction is advisable in patients with risk factors of eventration.

[Endoprosthetic replacement with lifting of abdominal wall in treatment of umbilical and postoperative ventral hernias].

The results of complex clinical and ultrasonic investigation of abdominal wall and following surgical treatment in 60 women with umbilical and postoperative large ventral hernias combined with abdomen ptosis were analyzed. Patients were divided into 2 groups with 30 people per group. Endoprosthetic replacement of abdominal wall defect using standard polypropylene prosthesis was applied in the 1st group, endoprosthetic replacement with musculoaponeurotic tissues lifting in hypogastric area using original super lightweight polypropylenepolyvinylidenefluoride prosthesis--in the 2nd group. Polypropylene endoprosthesisconsist of main flap 15×15 cm with roundish edges and additional flap 5×40 cm in the form of wide stripe placed at the lower edge of main flap transversely to its direction. It was revealed increased physical health component in 1.8 times, psychic--in 2.5 times in the 2nd group. Thus number of excellent results increased on 33.3% and amount of satisfactory outcomes reduced on 30%.