Analysis of the causes of recurrent postoperative ventral hernias

Tarasova, N. K.; Дыньков, С М; Поздеев, В. Н.; Teterin, Alexey; Osmanova, G Sh

doi:10.17116/hirurgia201910136

Cited by 4 publications

(2 citation statements)

References 6 publications

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“…There are a number of factors that affect recurrence after IH repair. Common patient-related factors are age, high BMI, chronic illnesses, diabetes mellitus, and early physical exertion following surgery [18]. Technical factors that may contribute to recurrence include the size of the defect, type of procedure (i.e., suture versus mesh repair), wound infection, and type and plane of mesh placement [19][20].…”

Section: Discussionmentioning

confidence: 99%

Onlay Versus Sublay Mesh Repair for Incisional Hernias: A Systematic Review

Pereira¹,

Gururaj²

2023

Cureus

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Incisional hernias are a common problem following major abdominal surgery. There are numerous surgical techniques described in the existing English scientific literature with different planes for mesh placement. The current review aims to compare onlay versus sublay repair in managing incisional hernias. A systematic literature search was conducted on Embase, the Cochrane Library, PubMed, and Medline to identify randomised controlled trials (RCTs) comparing onlay versus sublay mesh repair for incisional hernias. We identified six RCTs that included 986 patients, of whom 503 were in the onlay group and 485 were in the sublay group. There was no statistically significant difference in hernia recurrence between the onlay and sublay groups (odds ratio (OR): 1.3 (0.49-3.47), 95% confidence interval (CI), p=0.60). Seroma formation was significantly higher in the onlay group (OR: 2.85 (1.74-4.67), 95% CI, p<0.0001). There were 45 reported cases of surgical site infection (SSI). There was no significant difference between the two groups (OR: 1.46 (0.44-4.84), 95% CI, p=0.54). Haematomas were reported in 11 cases, and there was no significant difference between the two groups (OR: 2.13 (0.56-8.19), 95% CI, p=0.27). Four RCTs reported the length of the hospital stay. There was no significant difference between the two groups (mean difference (MD): 0.53 (-0.16-1.22), 95% CI, p=0.13). We failed to draw conclusive clinical recommendations due to the variability in the included RCTs. We recommend well-structured, large-volume RCTs to better compare these two surgical techniques.

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Section: Discussionmentioning

confidence: 99%

Onlay Versus Sublay Mesh Repair for Incisional Hernias: A Systematic Review

Pereira¹,

Gururaj²

2023

Cureus

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“…Риск осложнений при ретромускулярной пластике значительно ниже, вследствие хорошего кровоснабжения мышечной ткани формируется плотная соединительная ткань, и из-за внутрибрюшного давления, сетка более плотно примыкает к передней брюшной стенке, тем самым снижается риск рецидива. Так же необходимо подбираться правильный размер сетки для закрытия грыжевого дефекта, так как сетка имеет способность к сморщиванию, и возникает риск развития ПОВГ [22].…”

Section: пластика с помощью дополнительных биологических или синтетических материаловunclassified

General views on treatment technologies for patients with incisional ventral hernia

Лукоянычев

Izmailov

Емельянов

et al. 2021

Issled. prakt. med. (Print)

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Nowadays, the problem of surgical treatment of incisional ventral hernia (IVH) still remains significant. According to the statistical data, the number of patients with postoperative ventral hernias has increased by more than 9 times over the past 25 years. Experts offer many solutions to this problem every year and the surgeon have to find the best method of postoperative rehabilitation in the flow of information. Academic research databases Google Scholar, CyberLeninka and others were used to search for the relevant literature. The following conclusions were drawn from this review. The etiology of IVH is multifactorial. There is no generally accepted evidence-based gradation of risk factors. There is no unified system for selecting the method of hernia repair of the anterior abdominal wall in patients with IVH. The choice of allotransplant material and the method of hernia repair are often individual. The value of the critical level of intraabdominal pressure have not been specified, however, all authors agree that its monitoring should become routine. The sublay technique remains the "gold standard" of plastic surgery by aponeurotic flap, inlay should be used when sublay is impossible to perform. Onlay should be used as a reserve method. In some situations, combinations of techniques are required. More and more laparoscopy is being introduced in the treatment of IVH as an assistance and in therapy. The introduction of new methods of hernia repair based on the uncontrolled separation of the anatomical structures of the abdominal wall imposes special requirements on surgical technology: plastic material, instrumental and technical support, wound closure and pharmacological support, especially in conditions of increased intra-abdominal pressure and tissue tension. We can use medication of pyrimidine’s row (xymedon) for a better implantation of the mesh implant and to increase the resistance of local tissues.

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Possibilities of regulating the reaction of tissues of the implantation area with pyrimidine preparations after prosthetic repair of the hernia ring in the experiment

Лукоянычев

Izmailov

Evsyukov

et al. 2022

Issled. prakt. med. (Print)

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Purpose of the study. Study of the possibilities of pharmacological regulation of local and systemic inflammatory response, stimulation of reparative regeneration in prosthetic repair of abdominal wall hernias.Materials and methods. The experiment was carried out on 92 rats of both sexes of a pure line, divided into 4 groups. Group I (control) received only 1 ml of 0.9 % sodium chloride solution. Group II – hydroxyethyldimethyldihydropyrimidine 21 mg/day. Group III – potassium orotate 10.5 mg/day. Group IV – methyluracil 14 mg/day. Under anesthesia a mesh implant 4 × 2 cm was placed in the layer between the hypodermis and the superficial fascia. Animals were withdrawn from the experiment on days 5 (n = 52) and 14 days (n = 40). The site of implantation for histomorphometric studies captured the dermis, hypodermis, implant layer, fascia, and muscle. The preparation and staining of the preparations were carried out with hematoxylin-eosin and by Mallory.Results. 1. On the 5th day after the operation group II (hydroxyethyldimethyldihydropyrimidine) was characterized by pronounced neovasculogenesis (p = 0.002, U-test) and more active processes of formation and maturation of connective tissue (p = 0.024, U-test) with a low immune response to a foreign body (p = 0.044, U- test). III (potassium orotate) and IV groups (methyluracil) were characterized by a pronounced decrease in the inflammatory response with a simultaneous increase in tissue edema (p < 0.001, U-test), slowing down the formation and maturation of connective tissue (p = 0.016, U-test). 2. On the 14th day after the operation, group II (hydroxyethyldimethyldihydropyrimidine) was characterized an increase in the area of neovasculogenesis by 208.0 % (p < 0.001, U -criterion), a decrease in the volume of fluid accumulations by 63.4 % (p < 0.001, U-criterion), an increase in the processes of formation and maturation of connective tissue, mainly due to an increase in the number of fibrocytes by 333.3 % (p < 0.001, U-criterion). The parameters of the immune response to a foreign body had significant differences (p < 0.001, U-test).Conclusion. The use of potassium orotate and methyluracil reduces the inflammatory response in the tissues of the implantation area, however, it is associated with the appearance of liquid components and with a decrease in the formation of connective tissue cells. The use of hydroxyethyldimethyldihydropyrimidine is devoid of the above disadvantages, it is characterized by the predominance of regeneration and neovasculogenesis processes, which allows it to be used as a pharmacological support drug for prosthetic hernioplasty.

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Analysis of the causes of recurrent postoperative ventral hernias

Cited by 4 publications

References 6 publications

Onlay Versus Sublay Mesh Repair for Incisional Hernias: A Systematic Review

Onlay Versus Sublay Mesh Repair for Incisional Hernias: A Systematic Review

General views on treatment technologies for patients with incisional ventral hernia

Possibilities of regulating the reaction of tissues of the implantation area with pyrimidine preparations after prosthetic repair of the hernia ring in the experiment

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