[Application of the mesh implants in the patients with eventration].

The causes of occurrence and clinical signs of eventration were analyzed. Such hemostasis disorders as hypoproteinemia, anemia, avitaminosis, pneumonia, hyperglycemia, coagulopathy constitute a common factors predisposing to eventration development. There was established, that eventration always coexists with progressing intoxication. There were proposed the methods of operative interventions, using propylene mesh implantation, what permits to improve the results of the patients treatment significantly.

[Peculiarities of operative treatment of complicated forms of abdominal hernias].

The experience of treatment of 150 patients, suffering complicated forms of postoperative abdominal hernias (PAH), was summarized, In majority of patients the large and giant hernias, on a background of associated diseases, were revealed. It was established that complicated forms of PAH are associated with local or systemic infection component, causing the necessity of complex prophylactic measures conduction. Autoplastic and prosthetic methods of operations were applied; the indications for implantation procedures were elaborated. The analysis of lethality and early postoperative complications rate was conducted. Late results were studied up to ten years after the operation. The hernia recurrence had occurred in 12 (7.8%) patients.

[Optimization of prevention of postoperative purulent-inflammatory complications in patients, operated on for diseases of the abdominal cavity organs].

There were examined 59 patients with diseases of the abdominal cavity organs, in whom high risk of postoperative purulent-inflammatory complications was established. There were conducted 652 different sowing on various stages of operative intervention conduction to study up the operative field and the blood microflora. There was established, that in microbal scenery in the patients of the risk group the mixed bacterial-fungal infection prevails. Complex of prophylactic measures, which approves the reduction of the purulent-inflammatory complications occurrence, was proposed.

[Treatment of eventrations]. / Lechenie éventratsii.

Under study were 113 cases of eventrations. The paper presents general principles of conservative and surgical treatment. In operations for complete and true eventrations transplants of dura mater were used in order to additionally strengthen the frontal abdominal wall and to delimit the abdominal cavity from the operation wound. Clinical tests of this method in the treatment of 31 patients have revealed its advantages (there were no recurrences of eventration and no intestinal fistulas).

[Classification criteria and modern principles of surgical treatment for postop abdominal wall hernia]. / Kriterii klassifikatsii i sovremennye printsipy khirurgicheskogo lecheniia posleoperatsionnoi gryzhi briushnoi stenki.

Issues of differentiated choice of hernial defect (HD) plasty in 546 patients with postoperative (PO) abdominal wall hernia (AWH), taking into account the most informative classification signs of the disease (the hernial protrusion size and localization, the HD width, frequency of recurrences) were discussed. Depending on character of topographic disorder in abdominal wall present four types of PO AWH were delineated. Diagnosis of the AWH type according to criterions proposed, using the ultrasonic and computer tomography data, had permitted to determine the technical conditions and to substantiate pathogenetically the expediency of radical hernioplasty performance in 483 patients and of palliative HD correction--in 63. There was stressed the necessity to indicate technique of the hernioplasty performed, while depicting the operation using terminology "hernioplasty without tension" whether the HD edges were confronted side by side or not, what means performance of radical vs palliative procedure. Indications to performance of alloplasty, using synthetic net-like polymeric materials in all the patients with PO AWH were substantiated.

[Explantation of synthetic net-like materials in the treatment of large postoperative abdominal wall hernia]. / Eksplantatsiia sinteticheskikh setchatykh materialov pri lechenii posleoperatsionnoi gryzhi briushnoi stenki bol'shikh razmerov.

The results of explantation of synthetic netted materials in 82 patients with vast and giant postoperative abdominal wall hernia were analyzed. Physical and biological properties of netted explants made from polypropylene permit to apply them while infectioning of the operative field occurs and providing measures of complex prophylaxis for purulent-inflammatory, broncho-pulmonary and cardio-vascular complications. The method of plasty choice depends on clinical situation present, the operative risk degree, the hernial defect size and magnitude and on the stage of prognosticated intraabdominal pressure raising. An early postoperative complications were noted in 14 (17%) of patients. Hernial recurrency had occurred in 3 patients in terms of follow-up from 1 to 5 years.

[The complications of wound healing after an operation for ventral hernia and their prevention]. / Oslozhneniia zazhivleniia rany posle operatsii po povodu gryzhi zhivota i ikh profilaktika.

For abdominal hernia 982 patients were operated. The complications had occurred in 18.6% of patients due to chronic inflammation and the presence of "sleeping" infection in the hiatal gates margins. Application of the elaborated prophylaxis complex of measures had permitted to lower the frequency of the wound healing complications down to 9%.

[Simultaneous operations--the nomenclature and the definition]. / Simul'tannye operatsii--nazvanie i opredelenie.

304 operations with simultaneous herniotomy were performed on 282 patients for different associated diseases. Most frequent combinations of the diseases coexistent with ventral hernias, specific features and immediate results of the operations are described. The opinions of different scientists on the name, definition and essence of simultaneous operations are analyzed. The authors propose their personal definition of the simultaneous operations.

[A new method for plastic repair of the inguinal canal in treating inguinal hernias]. / Novyi sposob plastiki pakhovogo kanala pri lechenii pakhovykh gryzh.

An analysis of the 20-years experience with treatment of inguinal hernias is presented. Patients with "light" forms of inguinal hernias and with a good condition of the posterior wall, inconsiderable widening of the deep opening of the inguinal canal can be successfully treated by Martynov's and Girard's methods. In complicated forms of the inguinal hernia it is necessary to strengthen the posterior wall of the inguinal canal, in cases with big recurrent and repeatedly recurring hernias it must be completely reconstructed, often with the help of alloplasty. A method of alloplasty of the inguinal canal is proposed for complicated forms of inguinal hernias. Operations were made on 62 patients, recurrent hernias were noted in 2 patients (3.4%). Another method of operations is proposed used in men of young and middle age excluding traumas of elements of the spermatic cord. Operations were performed on 111 patients, recurrences were noted in 2 of them (2%).

[A method for the musculoaponeurotic plastic repair of complex abdominal hernias]. / Sposob myshechno-aponevroticheskoi plastiki slozhnykh gryzh zhivota.

A method for plasty of the complex forms of postoperative and umbilical hernias is described. The muscular-aponeurotic edges of the hernial ring are sutured in such a way to make the peritoneal leaflet adjoin each other. Use of the method mentioned permits approximation of the similar tissues, reduction in their tension when suturing and maximum preservation of the volume of the abdominal cavity. Decrease in incidence of the disease recurrences from 40 to 16% was noted.