Preventive endoprosthetic replacement of the abdominal wall after midline laparotomy

Kulikova N.A.

doi:https://doi.org/10.17116/operhirurg2018203138

Kulikova N.A.

Far Eastern State Medical University, Ministry of Health of Russia, Khabarovsk, Russia

Preventive endoprosthetic replacement of the abdominal wall after midline laparotomy

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Kulikova N.A.

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Journal: Russian Journal of Operative Surgery and Clinical Anatomy. 2018;2(3): 38‑45

DOI: 10.17116/operhirurg2018203138

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To cite this article:

Kulikova NA. Preventive endoprosthetic replacement of the abdominal wall after midline laparotomy. Russian Journal of Operative Surgery and Clinical Anatomy. 2018;2(3):38‑45. (In Russ.)
https://doi.org/10.17116/operhirurg2018203138

Подписка 2026 Оперативная хирургия и клиническая анатомия (Пироговский научный журнал) (Russian Journal of Operative Surgery and Clinical Anatomy)

Использование инфографики авторами научных работ

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Abstract:

Objective. To clarify indications for preventive endoprosthetic replacement and to elaborate an algorithm for preventing postoperative ventral hernias according to the degree of risk for their development, as well as an algorithm for selecting the level of fixation of an endoprosthesis according to the risk of wound complications. Subjects and methods. A comparison group included 93 patients who had undergone midline laparotomy. Eighteen (19.3%) patients of them developed postoperative ventral hernias within 1 and 3 years. A study group consisted of 107 patients, whose prevention of postoperative ventral hernias had been based on the algorithm elaborated by the author. In this group, 19 (17.8%) patients had an extremely high risk for postoperative ventral hernias; among whom, 9 patients underwent preventive endoprosthetic replacement. Results and discussion. The scale proposed by B.S. Sukhovatykh et al. was used to determine indications for preventive endoprosthetic replacement. Examining the comparison group patients with this scale showed that postoperative hernias more commonly developed in the patients who had a total of 16 scores or more or who had previously undergone midline laparotomies. The study group patients were divided into 2 groups: 1) those who had undergone preventive endoprosthetic replacement; 2) those who had not. The follow-up of the patients did not reveal that those in Group 1 developed postoperative ventral hernias; hernias developed in 30% of cases in Group 2. In Group 1, four patients underwent intra-abdominal hip replacement using a composite endoprosthesis; no postoperative complications were recorded. Supraaponeurotic endoprosthetic replacement using a polypropylene endoprosthesis was performed in 5 patients; one case was found to have a seroma. Conclusion. The indications for preventive endoprosthetic replacement have been clarified. The algorithm for the prevention of postoperative ventral hernias has been elaborated according to the degree of risk for their development. The algorithm for selecting the level of fixation of an endoprosthesis has been developed according to the risk of wound complications.

Keywords:

postoperative ventral hernia

preventive endoprosthetic replacement

composite endoprosthesis

Authors:

Kulikova N.A.

Far Eastern State Medical University, Ministry of Health of Russia, Khabarovsk, Russia

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References:

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