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Outcomes of surgical treatment of obese patients with ventral and incisional hernias

机译:患有腹侧和切口疝的肥胖患者的外科治疗结果

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摘要

Introduction. The results of the surgical treatment of ventral and incision hernias in the obese patients are poor, because of the high incidence of complications and relapses.The objective of the study was to analyse the outcomes of patients with hernias, obesity and non-specific connective tissue dysplasia (NSCTD), and to define the main predictors of complications development.Methods. We analysed the outcomes of treatment in 1133 patients, who underwent surgery for primary and incision ventral hernia between 2006-2017.Results. Pulmonary embolism was diagnosed in 0.62% of the patients, abdominal compartment syndrome (ACS) in 3.0% of the individuals, after stretching hernioplasty. The highest incidence of wound complications was evidenced in patients with stage 3 obesity – 35.14%. The signs of NSCTD were present in 53.45% of the patients with recurrent hernia, and in 18.61% of the patients with no recurrence of hernia. In patients with obesity stage 1 and 2, the development of ACS depended only on the chosen method of surgical intervention. In patients with no recurrent hernia, the division of patients according to their blood groups did not significantly differ from the general population.Conclusions. The non-stretching methods of hernioplasty should be a priority, especially for patients with morbid obesity, stage 2-3, and significant comorbidity. The risk group for relapses also includes the patients with NSCTD and A(2) blood group, since the incidence of NSCTD in these individuals is statistically significantly higher.
机译:介绍。肥胖患者腹部和切口疝的手术治疗的结果差,因为并发症的发病率高,并复发。该研究的目的是分析疝气,肥胖和非特异性结缔组织发育不良(NSCTD)的患者的结果,并定义并发症发展的主要预测因子。方法。我们分析了1133名患者的治疗结果,在2006 - 2017年期间接受了对初级和切口腹疝的手术。结果。在拉伸植物成形术后,在3.0%的患者中诊断为0.62%的患者,腹腔室综合征(ACS)的肺栓塞。第3阶段肥胖症的患者证明了伤口并发症的最高发病率 - 35.14%。 NSCTD的迹象显示在53.45%的患者中患有复发性疝的患者,18.61%的患者患者没有疝气复发。在肥胖阶段1和2的患者中,ACS的发展仅取决于所选择的外科手术方法。在没有复发疝的患者中,根据血液团体的患者分裂没有与一般人群显着不同。结论。封闭术的非拉伸方法应优先考虑,特别是对于病态肥胖,第2-3阶段和显着的合并症的患者。复发的风险组还包括NSCTD和A(2)血基的患者,因为这些个体中NSCTD的发病率有统计学显着提高。

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  • 作者

    Volodymyr I. PIATNOCHKA;

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  • 年度 2019
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  • 原文格式 PDF
  • 正文语种 eng;fra/fre
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