[Prevention of postoperative ventral hernias: current state of the art]

[Preventive abdominal wall reconstruction in patients with risk factors of eventration undergoing emergency abdominal surgery]

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.

[Postoperative ventral hernia - unsolved issues of surgical tactics]

Currently, there is no unified opinion on some problematic issues of surgical treatment of postoperative ventral hernias. Current approaches and surgical aspects of primary and recurrent postoperative ventral are reviewed in the article.