Morphological diagnosis of connective tissue dysplasia in patients, suffering postoperative abdominal hernia

The results of treatment of 122 patients, to whom alloplasty for postoperative abdominal hernia (POAH) was performed, were analyzed. In 76 patients a connective tissue dysplasia (CTD) was diagnosed.Determination of a various types of collagen content in connective tissue of patients, suffering CTD, may confirm or exclude this diagnosis. Diagnostic significance has the enhancement of a collagen type III content in comparison with such of a type I by three times and more. The method of lectinohistochemical investigation of connective tissue was applied as a precision-enhancing method of a CTD diagnosis. Mosaic or diffuse loss of SNA, LABA, ConA receptors of lectins by collagen fascicles, which reflect carbohydrate determinants of dense and strong collagen fascicles, made of collagen type I, witness the CTD presence. Along with this, there was observed a lectin WGA receptors expression increase, which constitutes a marker of fascicular structures, made of collagen, predominantly type III and a lectin PNA receptors, which are revealed around vessels.     

Rehabilitation and the quality of life estimation in patients suffering postoperative abdominal hernia before and after performance of reconstructive operation

The modern approach to rehabilitation and the quality of life securing in patients suffering postoperative abdominal hernia was elucidation. Using the rehabilitation algorrhythm elaborated in 69 (88.5%) patients suffering extent and giant hernia, satisfactory result was achieved after reconstructive operation performance, which had guaranteed the sufficient quality of life level. Poor result was noted in 9 (11.5%) patients, of them in 4 (5.1%) the disease recurrence had occurred, 5 (6.4%) were directed to expert medico-social commission. In these patients the quality of life indices did not differ from their values, presenting before the operation.     

Impact of abdominoplasty on quality of life in patients, suffering anterior abdominal wall deformity and obesity

The modern tendencies of surgery development include not only the operative procedures improvement but guaranteeing also a maximally high level achievement in the patients quality of life in the early, as well as during remote, postoperative period. The quality of life analysis was done in 132 patients, operated on for the anterior abdominal wall defects, obesity and other surgical diseases, using special questionnaire SF-36. The patients have aged 23-65 years old, in all of them the excessive body mass or obesity of abdominal type was noted.     

Correction of a connective tissue dysplasia in the treatment of postoperative abdominal hernias

There were analyzed the results of treatment of 112 patients, suffering postoperative abdominal hernia, in whom the anterior abdominal wall alloplasty was performed as well as postoperative pathogenetically substantiated complex therapy, taking into account the presence of a connective tissue dysplasia syndrome (CTDS) and the early and late postoperative complications prophylaxis. The peculiarities of postoperative period course and late follow-up results were studied up. Phenotypic features of CTDS were revealed in 53 (47.3%) patients, immunohistochemical features of a connective tissue dysplasia (a failed collagen type I and III ratio, manifested by increase of a collagen type III fibers quantity in 3 or more times) were revealed in 78 (69.6%) patients, in whom the processes of a collagen and its supermolecular formations synthesis were stimulated, using a magnesium orotate (Magnerot), which was prescribed in 1 g dose twice a day during 4 - 6 weeks. Application of composite nets, owing big pores, in a complex with a postoperative pathogenetically substantiated therapy conduction have positively influenced the disease course and the late follow-up results achieved.     

The role of connective tissue nonspecific dysplasia in postoperative and recurrent abdominal hernias formation

There were studied the rate of clinical indices diagnosis concerning nondifferentiated form of connective tissue dysplasia (NFCTD) as well as their significance in postoperative and recurrent abdominal hernias formation in 61 patients, ageing 20 - 78 years. It was established, that in 77% of patients the hernia have had formated on a NFCTD background, including in 16.4%--with a mild degree, in 27.8%--moderate degree and in 32.8%--a severe one. The authors recommend while abdominal hernia is present to study a characteristic phenotypical signs of a connective tissue dysplasia and, if more than 4 signs are diagnosed, to prefer the application of alloplastic methods.     

Peculiarities of treatment of patients, suffering postoperative peritonitis, complicated by abdominal sepsis

In 2001-2011 yrs 241 patients, 18-80 years old, including 148 (61.4%) men and 93 (38.6%) women, were treated in the clinic f postoperative peritonitis. In 156 (64.7%) patients abdominal sepsis was diagnosed. In 74 (83%) patients a puncture-draining interventions were performed under ultrasonographic control for local postoperative peritonitis, and relaparotomy - in 15 (16.9%). In 18 (11.8%) patients, suffering extended peritonitis, miniinvasive technologies were applied. For extracorporal detoxication in 96 (40%) patients the intermitting veno-venous hemodiafiltration was conducted as well as plasmapheresis, peritoneal dialysis. As a result of polyorgan insufficiency development 34 (14.1%) patients died, of them after miniinvasive interventions - 5 (5.4%).     

Surgical treatment of postoperative abdominal hernia

After surgical treatment of 664 patients with postoperative abdominal hernias (PAH) within the period of from 1972 to 1983, the incidence of recurrences was 48.4%. On the basis of studying microcirculation at the area of hernioplasty and its dependence on tissue tension force in the experiment on animals and at operations by means of radiometry, rheometry and fluorimetric analysis, the technique for surgical treatment of PAH with regard to location of a defect, including the method of plasty, system of preoperative preparation and prophylaxis of the postoperative wound complications, has been developed. From 1984, 200 patients with PAH were operated on, the incidence of recurrences decreased to 2.4%.     

The treatment of postoperative abdominal hernia

The results of treatment of 67 patients with postoperative abdominal hernia were analyzed. Approach to the choice of method and volume of operative intervention was proposed.     

The treatment of postoperative abdominal hernia

The experience with treatment of 450 patients with postoperative abdominal hernias with the use of autodermal plasty is presented. The incidence of hernia recurrences achieves 27.2%, lethality--1.6%.     

腹腔镜食管裂孔疝修补术并胃底折叠术对患者生存质量的影响

目的:探讨腹腔镜食管裂孔疝修补术并胃底折叠术对患者生存质量的影响。方法:采用消化病生存质量指数(gastrointestinal Lebens qualities index,GLQI)前瞻性地测定29例患者行腹腔镜食管裂孔疝修补术和胃底折叠术前,术后2周、1个月、3个月、6个月的生存质量值,并进行临床分析。结果:术前患者GLQI指数平均(83.62±13.14),明显低于正常人群(121～125分);术后2周平均(86.76±10.16),较术前有所升高,差异无统计学意义(P>0.05),但患者精神、心理较术前改善(P<0.05);术后1个月、3个月平均为(106.83±8.40)及(113.35±8.54),较术前及术后2周明显升高,差异有统计学意义(P<0.05);术后6个月平均(121.45±5.96),接近或达到正常水平。结论:腹腔镜食管裂孔疝修补术和胃底折叠术可提高患者术后生存质量,使其生存质量接近或达到正常人水平。     

Results of surgical treatment of postoperative abdominal hernia

There were examined 525 patients with postoperative abdominal hernia, in 47.3% of them big, vast and giant hernia was revealed. There were operated 436 patients using local tissues with duplicature formation--according to Mayo, Sapezhko, Napalkov and Yanov method.     

Alloplasty of giant postoperative abdominal hernia in middle aged and aged patients]

Surgical treatment of giant postoperative abdominal hernia was performed in 73 patients aged 63-73 yrs using additional plastic materials (polyurethane, polypropylene). The combined hernioplasty without stretching of tissues with disposition of implant in the hernial sac duplication was performed in 57 (78.1%) patients, in whom the abdominal wall defect revealed was 151-200 cm2; hernioplasty, forming artificial abdominal wall from the duplicated implant without reducing of the abdominal cavity volume--in 16 (21.9%) patients, in whom the hernial defect exceeded 200 cm2. An acute pulmonary-cardiac insufficiency had occurred in 2 (2.7%) of patients. One patient died. Recurrent hernia after the combined hernioplasty performance had occurred in terms from 1 to 5 years in 1 (1.9%) patient.     

Body wall dysplasia: a rare case of abdominal hernia

Malformations of the fetal abdominal wall include a broad spectrum of anomalies, and prenatal sonography provides the possibility of detecting most of them. Omphalocele and gastroschisis are the most common conditions, but there are other rare forms. We describe here a rare case of body wall dysplasia that we called abdominal hernia that appeared upon prenatal sonography as an omphalocele-like defect.     

综合护理干预对前列腺增生症合并腹股沟疝术后自我护理及生活质量的影响

目的探究综合护理干预对前列腺增生症合并腹股沟疝术后自我护理及生活质量的影响。 方法选取2018年3月至2020年3月于新疆维吾尔自治区人民医院就诊的132例前列腺增生症合并腹股沟疝术后患者,采用随机表法分为对照组和观察组,各66例。比较2组患者术后恢复情况、并发症发生率以及2组患者在护理干预前、出院时的焦虑自评量表（SAS）、自评抑郁量表（SDS）、生活质量调查简表（SF-36）评分,出院时患者对护理工作的满意度调查结果。 结果观察组患者术后恢复时间均短于对照组（P<0.05）。观察组患者术后的并发症发生率（3.03%）远低于对照组术后并发症发生率（9.09%）（P<0.05）。2组患者出院时SAS、SDS评分均比干预前明显降低,且观察组显著低于对照组（P<0.05）。出院时,2组患者生理健康总评（PCS）和心理健康总评（MCS）评分均较干预前有所升高（P<0.05）,且观察组PCS和MCS评分显著高于对照组（P<0.05）。出院时,观察组患者对护理工作各项满意度的评分均显著高于对照组（P<0.05）。 结论综合护理干预对前列腺增生症合并腹股沟疝患者的术后自我护理有着极好的引导作用,患者能够尽快适应术后变化,进而调动患者的自主能动性,提高患者生活质量。     

Clinico-functional evaluation of the effectiveness of preoperative care of patients with postoperative abdominal hernia

In 27 patients with postoperative abdominal hernias, on the basis of studying the indices of respiration, hemodynamics, ABB and blood gas, it was established that preoperative preparation lasting 9-12 days provided adaptation of the respiratory and circulatory systems to the increased intraabdominal pressure.     

Surgical treatment of postoperative abdominal hernia after angular laparotomy

Six observations of postoperative abdominal hernia occurrence after the angular laparotomy performance were adduced. Surgical treatment in two stages was performed: at first the lateral part of the hernial defect was sutured and after--the middle one.