Infectious and inflammatory complications after endoscopic hernioplasty in patients with postoperative ventral hernias: features of diagnosis and treatment strategies
- Authors: Semenov V.V.1, Prudyeva S.А.1, Kurygin A.A.1
-
Affiliations:
- Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
- Issue: Vol 23, No 3 (2021)
- Pages: 157-164
- Section: Clinical trials
- URL: https://journals.rcsi.science/1682-7392/article/view/75485
- DOI: https://doi.org/10.17816/brmma75485
- ID: 75485
Cite item
Abstract
An algorithm for the diagnosis and treatment of infectious and inflammatory complications after endovideosurgical hernioplasty in patients with postoperative ventral hernias using traditional and minimally invasive methods of therapy was proposed. The study was based on the treatment results of 177 patients who underwent endovideosurgery for postoperative ventral hernias. Despite the perioperative antibiotic prophylaxis according to the accepted at the S.M. Kirov Military Medical Academy, according to the protocol scheme (first-generation cephalosporin at a dose of 1 g once parenterally 30 min before the operation, followed by repeated administration in case of operation duration of > 3 h), course of the early postoperative period on days 3–5 in 8 (4,5%) patients after endovideosurgical hernioplasty was complicated by suppuration in the intervention area. When analyzing the causes of infectious and inflammatory complications, in both the main and control groups of observations, all suppuration in the area of surgical interventions was diagnosed in patients with metabolic syndrome (stages II–III obesity and type 2 diabetes mellitus). The use of the “negative pressure wound therapy” resulted in wound cleansing for 4.1 ± 2.5 days (p < 0.05) and was comparable with the traditional method of treatment, but more active growth of granulation tissue prevailed in the wound, which contributed to its accelerated healing. The “negative pressure wound therapy” is effective in the systemic infectious and inflammatory process, especially after prosthetic hernioplasty of large W3-postoperative hernias. Drainage of abscesses under ultrasound navigation is possible with small (S ≤ 10 cm2) delimited purulent processes in the area of the polypropylene implant with the preservation of the latter.
Keywords
Full Text
##article.viewOnOriginalSite##About the authors
Valery V. Semenov
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
Author for correspondence.
Email: semvel-85@mail.ru
ORCID iD: 0000-0003-1025-332X
SPIN-code: 1481-2592
candidate of medical sciences
Russian Federation, Saint PetersburgSofya А. Prudyeva
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
Email: sofia.prudieva@yandex.ru
SPIN-code: 4453-2100
doctor-surgeon
Russian Federation, Saint PetersburgAlexander A. Kurygin
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
Email: kurygin60@gmail.com
doctor of medical sciences, professor
Russian Federation, Saint PetersburgReferences
- Belokonev VI, Gogiya BSH, Gorskij VA, et al. Nacional’nye klinicheskie rekomendacii po gerniologii. Razdel Posleoperacionnye ventral’nye gryzhi. Moscow: 2017. 55 p. (In Russ.).
- Belokonev VI, Pushkin SYU, Fedorina TA. Biomekhanicheskaya koncepciya patogeneza posleoperacionnyh ventral’nyh gryzh. Grekov’s Bulletin of Surgery. 2004;5:23–27. (In Russ.).
- Burdakov VA. Endoscopic extraperitoneal subspecies v lechenii patsientov s primary and postoperative ventral hernia. Endoscopic surgery. 2019;25(4);34–40. (In Russ.). doi: 10.17116/endoskop20192504134
- Kurygin AlA, Romashchenko PN, Semenov VV, et al. Laparoscopic elimination of large strangulated umbilical hernia and hernia of the white line on the ipom technique. Grekov’s Bulletin of Surgery. 2018;177(4):73–75. (In Russ.). doi: 10.24884/0042-4625-2018-177-4-73-75
- Romashchenko PN, Kurygin AlA, Majstrenko NA, Semenov VV, et al. Sluchaj uspeshnogo hirurgicheskogo lecheniya triady Sejnta v sochetanii s bol’shimi posleoperacionnymi ventral’nymi gryzhami (2534-e zasedanie Hirurgicheskogo obshchestva Pirogova 23.10.2019 g.). Grekov’s Bulletin of Surgery. 2020;179(1):113–119. (In Russ.). doi: 10.24884/0042-4625-2020-179-1-113-119
- Romashchenko PN, Kurygin AlA, Semenov VV. Laparoskopicheskaya gernioplastika po metodike IPOM v lechenii bol’nyh ventral’nymi gryzhami. Materialy XX S'ezda Obshchestva endoskopicheskih hirurgov Rossii. Al’manah instituta hirurgii imeni Vishnevskogo AV. 2017:1033–1034. (In Russ.).
- Romashchenko PN, Kurygin AlA, Semenov VV, Polushin SYU, et al. Justification and direct results of endoscopic gynryoplastics with tapp and tep techniques. Bulletin of the Russian Military Medical Academy. 2019;(1):125–128. (In Russ.).
- Samarcev VA, Gavrilov VA, Parshakov AA, Kuznecova MV. Posterior separation hernioplasty tar in treatment of postoperative ventral hernias W3. Perm Medical Journal. 2017;34(1);35–42. (In Russ.).
- Semenov VV, Kurygin AlA, Romashchenko PN, et al. Endovascular Treatment of Patient with Strangulated Amyand’s Hernia. Grekov’s Bulletin of Surgery. 2017;176(2):112–114. (In Russ.).
- Ansari MM. Surgical preperitoneal space: holy plane of dissection between transversalis fascia and preperitoneal fascia for TEPP inguinal hernioplasty. MOJ Surg. 2018;6(1):26–33. doi: 10.15406/mojs.2018.06.00119
- Awaiz A, Rahman F, Hossain MB, et al. Meta-analysis and systematic review of laparoscopic versus open mesh repair for elective incisional hernia. Hernia. 2015;19(3):449–463. doi: 10.1007/s10029-015-1351-z
- Belyanskу I, Daes J, Radu VG, et al. A novel approach using the enhanced view totally extraperitoneal (eTEP) technique for laparoscopic retromuscular hernia repair. Surg Endosc. 2018;32(3):1525–1532. doi: 10.1007/s00464-017-5840-2
- Carbonell AM. Rives-Stoppa retromuscular repair. Hernia Surg: Springer Int Publ Switz. 2016;107–115. doi: 10.1007/978-3-319-27470-6_12
- Novitsky YW, Elliott HL, Orenstein SB, et al. Transversus abdominis muscle release: a novel approach to posterior component separation during complex abdominal wall reconstruction. Am J Surg. 2012;204(5):709–716. doi: 10.1016/j.amjsurg.2012.02.008