Pharmacological correction of formation of connective tissue with mesh hernia repair in experiment

The use of foreign materials in modern herniology, on the one hand, reduces the number of recurrences, and on the other - increases the risk of several complications: profuse exudation and possible infection in the postoperative wound, extensive cicatricial deformation of a zone of operations, persistent pain syndrome and possible reduced fertility in men. In the experiment 30 rats were studied influence of drugs «mesogel®» and «iodopiron» in the course of wound process during operations using mesh explant. Histological methods were evaluated the usefulness of the formation of connective tissue, degree of involvement in cicatricial process is located in the area of operation of tissues and structures. Compared with the control group of animals is set to a relatively low density and fewer collagen fibers. In the control group of animals had a marked proliferative response in the surrounding tissue prosthesis, gross deformity and involvement in the scar process near structures

CLINICAL AND IMMUNOHISTOCHEMICAL STUDIES IN THE DIAGNOSIS OF UNDIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA IN PATIENTS WITH CHOLELITHIASIS

There were examined 132 patients in the age of 29-77 years old. Morphological features of abnormal shape or position of gallbladder were detected at 26.9% of patients with undifferentiated connective tissue dysplasia, and this may contribute to the formation of gallstones

LONG-TERM RESULTS OF VARIOUS TREATMENT OPTIONS FOR VENTRAL HERNIAS

In modern herniology tension free technic of hernia repair is a leading, thanks mainly to fewer recurrences. However, hernia repair breaks anatomy and functionality of the anterior abdominal wall, which leads to a deterioration in the quality of life of patients. Objective: To analyze the quality of life of patients after hernia repair ventral hernias. Materials and Methods: The analysis of the results of surgical treatment of 199 patients with ventral hernias after hernia repair in 6 months. For the study used questionnaires quality of life using the SF-36 form. Results: characteristics of each operation, positive and negative, are reflected in the indices of physical and mental health of the survey. Conclusions: onlay, inlay methods of hernia repair are characterized by the best indicators of physical health in the late postoperative period. Methods sublayplastics have a greater impact on the health of the patient in the postoperative period. However, mental health indicators surpass a simple hernia repair techniques

MINI-INVASIVE TECHNIQUES FOR LATERAL VENTRAL HERNIA TREATMENT

After surgical interventions with approaches through abdominal oblique muscles, we could observe lateral ventral hernias in 40% patients. They are less frequent in the structure of postoperative ventral hernias as such surgical approaches are not often employed. However, technical difficulties of abdominal wall repair and unsatisfactory immediate and long-term treatment results are to be observed by surgeons. Recurrence rate of lateral hernias after autoplasty is 20–30%, and following meshed explants application – 5%. These unsatisfactory outcomes in the operated on patients necessitate analysis of complication and recurrence causes and search for their possible ways of solutions.Objective. Improve results of surgery in patients with lateral postoperative ventral hernias.Material and Methods. For 2012–2017 we have operated on 36 patients with postoperative lateral ventral hernias: 15 with open approaches and 21 with laparoscopy. To analyse treatment results we have been monitoring early postoperative period for 7–10 days, analysed pain syndrome and complications – seromas, hematomas and wound complications. In 6 months and 1 year postoperatively we observed presence of chronic pain syndrome, satisfaction of patients with surgery results and lack of hernia recurrence.Results. After open surgery we observed 4 cases with seromas, pain syndrome according to VAS was from 7 to 8 points for 3–4 days. Hospital stay was 9 ± 2 days. Two patients complained pain syndrome in 6 months postoperatively and in a year after conservative treatment none of those suffered any pain syndrome. In an early postoperative period after laparoscopy there were no complications observed. Pain syndrome was 4–5 points according to VAS. Due to minor pain syndrome and lack of wound complications mean period of hospital stay was 5 ± 2 days. No pathological events in long term period linked to mesh transplant were not registered. Conclusion. Treatment of lateral hernias is complicated by lateral abdominal wall structure, presence of four nerve trunks and neuropathic element with hernia formation with denervation and lateral abdominal wall laxity. Laparoscopy has several advantages for surgical treatment of these type of hernias. Application of mini-invasive techniques for lateral ventral hernia treatment has impact on reduction of early postoperative complication rate and hospital stay and possible risk of pain syndrome development in a long-term postoperative period. This application is limited only by presence of adhesions or unfavourable comorbidities that increase risk of intraoperative complications related to necessitated intra-abdominal pressure elevation. In cases with contraindications for mini-invasive techniques one should perform open intramuscular or preperitoneal hemioplasty