USING OF ENDOPROSTHESISES IN TREATMENT OF THE STRANGULATED HERNIAS OF ANTERIOR ABDOMINAL WALL
S.V. IVANOV, I.S. IVANOV, R.A. MAMEDOV
Kursk State Medical University, Kursk, RUSSIA
Azerbaijan Medical University, Baku, AZERBAIJAN
One of the most serious complications of abdominal hernias is the strangulation which at inguinal hernias develops more than at 15 % of patients. Very often the strangulation develops at patients of elderly and senile age. The percent dangerous to a life of the patient of errors in recognition of the strangulated hernias of an abdominal wall can be substantially reduced under condition of observance of tactics of diagnostics and treatment of the strangulated hernias.73 emergency operative measures are spent to the period with 2007 on 2010 in the department of the general surgery of Kursk Regional Hospital concerning the strangulated hernias of anterior abdominal wall. Middle age of patients has made 68,4 years. Naturally most part of patients was made by women - 82,5 %, men – 17,5 %. In 2009 and 2010 the ascending tendency by quantity of patients became perceptible. Rising makes more than 43 %, in comparison with previous years that is bound to ageing of the population and an aggravation of symptoms of affairs in regional surgery of Kursk area. At all patients tactics of active dynamic, clinical and tool research of patients was applied. Applied tactics has allowed diagnosing the strangulation diagnosis on earlier terms. The special place in treatment of the restrained hernias occupies a question on a way of a plasty of primary hernias (PH) and postoperative ventral hernias (POVH), and as inguinal hernias. We almost have completely refused an autoplasty in favors of endoprosthesis methods. 85,9 % of operations at PH and POVH came to the end with not clamping plasty of type «onlay» with using polypropylene mesh «Esfil» and polyvynilidenfluorid mesh «Uniflex» with an obligatory drainage of area of standing endoprosthesis. Besides, use of endoprosthetic methods has considerably lowered level of eventration at POVH. We note reduction in 2,2 times of number of eventration at using of endoprosthesis techniques. Average of staying days during using of endoprosthesises was enlarged on 2,2±0,7 days. At inguinal hernias operation of choice, plasty application across Liechtenstein, as with use polypropylene mesh «Esfil». Average of staying days using endoprosthesis was enlarged on 1,5±0,3 days.Use of active tactics of diagnostics and surgical treatment at the strangulated hernias of a anterior abdominal wall have allowed to lower a postoperative lethality to 2,9 % in 2010
Thus, the timely reference behind medical aid, active clinical and diagnostic monitoring and use of methods of endoprosthesis allow to improve really results of treatment of patients with the strangulated hernias of a anterior abdominal wall.
Date: 2014-12-28; view: 217