Results of surgical treatment of patients of fertile age planning pregnancy with hernias of the anterior abdominal wall

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Abstract

BACKGROUND: Currently, there is no consensus and approved tactics for choosing the method of hernioplasty in the surgical treatment of patients of fertile age planning pregnancy with hernias of the anterior abdominal wall. The study is devoted to the comparative analysis of surgical treatment of these patients.

AIM: To determine the algorithm of surgical treatment of hernias of the anterior abdominal wall in the patients of fertile age planning pregnancy.

MATERIALS AND METHODS: The analysis of the treatment results of fertile age patients with hernias of the anterior abdominal wall in the period from 2010 to 2019 has been carried out. The inclusion criteria were as follows: patients of fertile age who underwent surgical treatment of hernias of the anterior abdominal wall, who did not have a relapse before pregnancy. Thus, 252 patients have been included in the study.

RESULTS: The surgical tactics and optimal timing of the operation in patients of fertile age with hernias of the anterior abdominal wall have been determined.

CONCLUSIONS: When planning surgical treatment of hernias of the anterior abdominal wall in patients of fertile age, it is necessary to clarify information about pregnancy planning. The most favorable period for planning pregnancy and childbirth is 3 years or more after hernioplasty. When planning a pregnancy in the next 1–2 years after surgical treatment of a ventral hernia, it is necessary to give preference to hernioplasty with local tissues, which has fewer complications in the long-term postoperative period as well as fewer relapses after childbirth compared with open prosthetic surgery. When planning a pregnancy 3 or more years after surgical treatment, preference should be given to prosthetic hernioplasty. When analyzing the results of treatment of the patients of fertile age with inguinal and femoral hernias, planning pregnancy, clinical experience has shown that there are no contraindications to performing laparoscopic transabdominal preperitoneal prosthetic hernioplasty.

About the authors

Badri V. Sigua

North-Western State Medical University named after I.I. Mechnikov

Email: dr.sigua@gmail.com
ORCID iD: 0000-0002-4556-4913
SPIN-code: 5571-8893

MD, Dr. Sci. (Med.), Professor

Russian Federation, Saint Petersburg

Dmitrii S. Semin

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: cosmo@list.ru
ORCID iD: 0000-0002-5630-4914
SPIN-code: 9434-4321
Scopus Author ID: 57194730925

MD, Cand. Sci. (Med.)

Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015

Dmitrii V. Gurzhiy

North-Western State Medical University named after I.I. Mechnikov

Email: gurzhiydv@ro.ru
ORCID iD: 0000-0002-4005-0403
SPIN-code: 7344-3941

MD, Cand. Sci. (Med.), Assistant Professor

Russian Federation, Saint Petersburg

Alexander A. Kozobin

North-Western State Medical University named after I.I. Mechnikov

Email: akozobin@mail.ru
ORCID iD: 0000-0003-1527-3848
SPIN-code: 6240-4321

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Vyacheslav P. Zemlyanoy

North-Western State Medical University named after I.I. Mechnikov

Email: yacheslav.zemlyanoy@szgmu.ru
ORCID iD: 0000-0001-7368-5926

MD, Dr. Sci. (Med.), Professor

Russian Federation, Saint Petersburg

References

  1. NKR po gerniologii. Razdel “Posleoperatsionnye ventral’nye gryzhi”. [Internet]. Russian Society of Surgeons. Available from: http://общество-хирургов.рф/upload/posleoper_ventraln2.doc. Accessed: 17.11.2022. (In Russ.)
  2. Bougard H, Coolen D, de Beer R, et al. HIG (SA) Guidelines for the management of ventral hernias. SAJS. 2016;54(3):1–29.
  3. Jafri SM, Vitous CA, Dossett LA, et al. Surgeon attitudes and beliefs toward abdominal wall hernia repair in female patients of childbearing age. JAMA Surg. 2020;155(6):528–530. doi: 10.1001/jamasurg.2020.0099

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