Retrospective research on initiative content reduction technique for obesity patients with huge abdominal incisional hernia

Abstract

OBJECTIVE: The objective of this study is to assess the prophylactic and therapeutic effects of initiative content reduction on intra-abdominal hypertension in obesity patients with huge abdominal incisional hernia. MATERIALS AND METHODS: In this study, the retrospective cohort/descriptive research methods were applied. We collected the clinical data of a total of 62 obesity patients with single-onset huge abdominal incisional hernia who were admitted to Beijing Chaoyang Hospital of Capital Medical University for treatment between January 2011 and December 2015. In the operation, the initiative content reduction was performed. Following observation indexes were recorded as follows: (1) Surgical condition: surgical duration, length of resected intestinal tract, and length of stay (LOS) in hospital; (2) postoperative recovery: cardiac, pulmonary, hepatic and renal functions, and and intravesical pressure; (3) incidence of postoperative complications: infection of incision and intestinal fistula; and (4) patients' condition in follow-up. Return visits in outpatient service were required respectively at 1 week, 1 month, 3 months and 6 months after surgery, and 1 year after follow-up, the follow-up was carried out through telephone. Recurrences of hernia and late-onset infection were the question to be asked in follow-up, and June 2016 was set as the deadline of follow-up. RESULTS: (1) Surgical condition: The surgeries were successfully carried out for 62 patients, in which surgical duration was (115 ± 22) min, the length of resected intestinal tract was (207 ± 64) cm, and LOS was (14.5 ± 1.9) d. (2) Postoperative recovery: the intravesical pressure of patients was decreased in comparison with the level before operation, and after surgery, no hepatic, renal and respiratory dysfunctions were observed. (3) Incidence of postoperative complications: There were four patients with infection of incision; however, no intestinal fistula was found in any patients. (4) Follow-up: follow-up was performed for 62 patients, and the average length of follow-up was 35 months, during which three patients suffered recurrence of incisional hernia. CONCLUSION: For obesity patients with huge abdominal hernia, the application of initiative content reduction can effectively prevent the postoperative intra-abdominal hypertension, which is considered as an effective and feasible therapeutic procedure.

Keywords

• huge abdominal hernia
• initiative content reduction technique
• intra-abdominal hypertension
• obesity