Comparative analysis of separation techniques in the treatment of medial ventral hernias

Abstract

Relevance. Tension-free herniolasty of the anterior abdominal wall is currently the accepted standard for large ventral hernia repairing. The implementation of this approach has been marked by a significant improvement in treatment outcomes. The issues of improving the quality of life of patients after surgery and their effective rehabilitation through the application of the optimal technique of tension-free hernioplasty are now at the forefront.Objective. To compare the immediate and long-term results of treatment of patients with large postoperative midline ven­tral hernias using anterior and posterior techniques of separation of abdominal wall components.Object and methods. 114 patients with large postoperative midline ventral hernias were divided into two groups: the patients of the first group (38 patients) underwent hernioplasty using the anterior separation technique, and the patients of the second group (76 patients) - posterior separation. We evaluated the immediate (complica­tions in the area of surgery, duration of surgical wound drainage and duration of hospitalization) and long-term (functional restoration of the abdominal wall) results of treatment with subsequent comparative analysis of data between the groups using descriptive statistics methods.Results. The present study is the first to compare the immediate and long-term results of using anterior and posterior techniques for separation of anterior abdominal wall components during surgery for midline ventral hernias. It was found that both variants demonstrate good immediate and long-term results in the treatment of patients with median postoperative ventral hernias of large size. At the same time, the anterior separa­tion technique is accompanied by a significantly higher number of complications and, accordingly, is characterized by a higher risk of their de­velopment, as well as requires a longer stay of the patient in the hospital.

Keywords

• midline ventral hernia
• hernioplasty
• anterior separation
• posterior separation
• polypropylene mesh implant
• immediate treatment results
• long-term treatment results
• comparative analysis