ASSESSMENT OF INTRA-ABDOMINAL PRESSURE DURING ALLOPLASTY OF POSTOPERATIVE VENTRAL HERNIAS AND PREVENTION OF INTRA-ABDOMINAL HYPERTENSION
DOI:
https://doi.org/10.32782/2226-2008-2023-2-14Keywords:
Intra-abdominal pressure, hernia, alloplasty, intra-abdominal hypertensionAbstract
The aim – optimize the prevention of intra-abdominal hypertension during alloplasty of postoperative ventral hernias of giant sizes. Materials and methods. An assessment of intra-abdominal pressure was evaluated in 232 patients with giant PVH aged from 33 to 77 years. The average age of patients is 56.4±1.3. The main group consisted of patients with postoperative ventral hernias of giant size, whose IАP was evaluated before surgery, during surgical treatment in order to optimize the choice of alloplasty method, immediately after surgery, 6-24 hours and 48 hours after surgery. The comparison group consisted of 80 patients with giant PGА for who surgical treatment was performed without evaluation of IАP indicators during surgery, in particular, only the posterior method of dividing the anatomical components of the abdominal wall according to Carbonell was performed. Results of the studies and their discussion. For 78 patients of the 1st subgroup with an IАP of 9.1±1.2 mm Hg, determined during the operation, the posterior method of disconnection of anatomical components according to Carbonell was performed in combination with sublay alloplasty. For 80 patients of the II subgroup with IАP from 11.1 to 14.1±1.2 mm Hg defined intraoperatively, the TAR technique was performed in combination with sublay alloplasty. For 74 patients of the III subgroup with IАP values from 16 to 20.1±1.2 mm Hg,was performed the TAR technique improved by us in combination with IPOM alloplasty. A reduction in the frequency of intra-abdominal hypertension was achieved for patients of subgroup I to 5.1% versus 11.2%, for patients of subgroup II to 5% versus 11.2%, and for patients of subgroup III to 1.4% versus 11.2% to the comparison group.
The article is available at the Institutional Repository of Odesa National Medical University http://journal.odmu.edu.ua/?p=7601&lang=en
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