Simultaneous interventions in surgical gastroenterology and herniology: prediction and prevention of complications

Abstract

The aim of the study - to improve the results of simultaneous surgical treatment of patients with large ventral hernias and incisional hernias W3 and concomitant surgical pathology of the abdominal organs. Material and methods. The article analyzes the results of surgical treatment of 450 patients with primary and postoperative hernias of the abdominal wall. 95 (21.1%) patients were urgently operated on. In 76 (16.9%) patients with large ventral and incisional W3 hernias, posterior separation hernioplasty was performed using TAP technology. In the presence of concomitant surgical pathology of the abdominal organs, simultaneous surgical interventions were performed. Results. In sublay and IPOM groups, 14 (3.7%) patients underwent laparoscopic sleeve resection of the stomach, 16 (4.3%) patients - laparoscopic cholecystectomy, and 4 (1.1%) patients -TAPP hernioplasty. In TAR group, 9 (11.8%) patients underwent open cholecystectomy, 12 (15.8%) - transverse abdominoplasty, 3 (3.9%) - open sleeve resection of the stomach, 2 (2.6%) - closure of the colostomy. The average duration of pain in the postoperative period was 4.5±0.9 days. The average duration of hospitalization was 9.7±1.1 days. In the postoperative period, 2 patients developed surgical site infection. There was no mortality. Conclusions. Modern simultaneous interventions in surgical gastroenterology and herniology with risk stratification of specific and nonspecific complications are an actuale social, medical and economic problem. An individual and differentiated approach to choice of simultaneous surgical intervention method taking into surgical and anesthetic risks and patients comorbidity, can reduce the percentage of postoperative complications and improve patient’s life quality.