SOME ASPECTS OF PATHOGENESIS OF THE VENTRAL HERNIAS

Abstract

Objective: To study some features of pathogenetic mechanisms of development of ventral hernias. Methods: The results of diagnostics and treatment of 140 patients with ventral hernias are analyzed. In 75 (53.6%) cases there were acquired hernias, and in 65 (46.4%) – postoperative cases. The size of the hernial protrusion of the latter is distributed as follows: giant (n = 12), large (n = 42), medium (n = 58) and small (n = 28). Results: To study the etiopathogenetic mechanisms of the origin of ventral hernias and their relapses in 60 (42.8%) observations of the parameters of lipid peroxidation (LPO) in the aponeurosis biopsy material and muscles with different sizes of hernial gates. Thus, the content of conjugated dienes and malonic dialdehyde in aponeurosis with large ventral hernia reached 1.7±0.07 μmol/mg and 3.5±0.03 μmol/mg, and in biopsies of rectus abdominal muscles 1.9±0.03 μmol/mg and 3.7±0.02 μmol/mg, respectively. The dependence between the content in the blood of the free hydroxyproline and the dimensions of a ventral hernia was noted. Thus, with small ventral hernias, these indices were 21.6±1.4 μmol/l, and for medium and large – 23.1±0.5 μmol/l and 24.2±1.1 μmol/l, respectively. Conclusion: When performing hernioplasty, it is advisable to excise the margins of the aponeurosis of the hernia gates zone, where there is a high content of LPO and the consequences of morphological changes, that allows reducing the frequency of relapse herniation development.

Keywords

• ventral hernia
• lipid peroxidation
• relapse.