Novosti
|
This journal is indexed in Scopus |
|---|
Year 2022 Vol. 30 No 1
GENERAL & SPECIAL SURGERY
B.I. BELOKONEV, S.Y. PUSHKIN, Z.V. KOVALEVA, D.B. AVEZOVA, D.V. NOVIKOV
TREATMENT METHODS OF PATIENTS WITH POSTOPERATIVE VENTRAL HERNIAS AND CREATED INTESTINAL FISTULAS
Samara State Medical University, Samara, Russian Federation
Objective. To substantiate the methods of surgical treatment in patients with postoperative ventral hernias and created intestinal fistulas based on the comparison of the outcomes of one-stage and two-stage operations.
Methods. The analysis of patients (n=40) with postoperative ventral hernias and created intestinal fistulas imposed for therapeutic purposes or created as the treatment outcomes of uncreated fistulas has been performed. Jejunal fistulas were present in 7 patients (17.5%), ileal fistulas in 18 (45%), and colonic fistulas in 15 (37.5%) patients. The patients of group 1 (n=15, 37.5% ) underwent the two-stage operations. First, the fistula was closed with the access to the site of its location, and then after 3-6 months, the excision of hernia was performed. In patients of group 2 (n=25, 62.5%) fistula was simultaneously removed and hernia was excised. The «tension-free» techniques in hernia orifice repair in those groups was performed. The outcomes were evaluated by the number of local and general complications in the period from 10 days to 6 months.
Results. Wound complications after the first operation developed in 2 (13.3%) patients in the 1st group. There were no complications after the second stage of hernioplasty. In group 2, wound complications developed in 3 (12%) patients. There was no anastomotic failure in the groups. In the long terms, good results were obtained in 15 patients in group 1 and in 25 patients in group 2. The use of anterior prosthetic «tension-free» techniques of plastic surgery by the combined methods in one-stage allows obtaining results comparable to two-stage operations.
Conclusion. In patients with hernias and intestinal fistulas, the method of treatment in one-stage or two-stages depends on the possibility of the gastrointestinal restoring patency from minimally invasive access in the site of the fistula location.
- Krieger AG, Kubyshkin VA, Berelavichus SV, Gorin DS. Caldarov AR. Gogiya BSH, Akhtanin EA, Matushevskaya VN, Sokolova EA. Surgical treatment of patients with enteric fistulae. Hirurgija. Zhurn im NI Pirogova. 2015;(12):86-95. doi: 10.17116/hirurgia20151286-95 ( In Russ.)
- Kulikov LK, Buslaev ÎÀ, Shalashov SV, Smirnov ÀÀ, Mikhaylov AL, Egorov IA, Shadarov LP, Sobolev ST,. Sobotovich VF, Privalov UA. Surgical treatment of extensive and giant ventral incisional hernias. Novosti Khirurgii. 2013 Mar-Apr; Vol 21 (2): 37-44 http://dx.doi.org/10.18484/2305-0047.2013.2.37 (In Russ.)
- Beffa LR, Warren JA, Cobb WS, Knoedler B, Ewing JA, Carbonell AM. Open retromuscular repair of parastomal hernias with synthetic mesh. Am Surg. 2017 Aug 1;83(8):906-910. doi: 10.1177/000313481708300845
- Demko AE, Batyrshin IM, Shlyapnikov SA, Ostroumova YuS, Sklizkov DS, Fomin DV, Pichugina GA. Staged approach in the treatment of patients with enterocutaneous fistulae. Khirurgiya. 2020;(11):66-73. doi: 10.17116/hirurgia202011166 (In Russ.)
- Ross H. Operative surgery for enterocutaneous fistula. Clin Colon Rectal Surg. 2010 Sep;23(3):190-94. doi: 10.1055/s-0030-1262987
- Arnold MR, Kao AM, Otero J, Marx JE, Augenstein VA, Sing RF, Colavita PD, Kercher K, Heniford BT. Mesh fistula after ventral hernia repair: What is the optimal management? Surgery. 2020 Mar;167(3):590-97. doi: 10.1016/j.surg.2019.09.020
- Timerbulatov MV, Ibatullin AA, Gaynutdinov FM, Kulyapin AV, Aitova L.R, Kyzylbaeva AI, Abdeev A.A, Fatkhullin AS. Late stomal complications and their surgical correction. Kazan Med Zhyrn. 2012;93(4):602-605.doi: 10.17816/KMJ1552 (In Russ.)
- Slater NJ, Knaapen L, Bökkerink WJV, Biemans MJA, Buyne OR, Ulrich DJO, Bleichrodt RP, van Goor H. Large contaminated ventral hernia repair using component separation technique with synthetic mesh. Plast Reconstr Surg. 2015 Dec;136(6):796e-805e. doi: 10.1097/PRS.0000000000001793
- Latifi R. Practical approaches to definitive reconstruction of complex abdominal wall defects. World J Surg. 2016 Apr;40(4):836-48. doi: 10.1007/s00268-015-3294-z
443099, Russian Federation,
Samara, Chapayevskaya Str., 89,
Samara State Medical University,
Department of Surgical Diseases No2,
tel. mobile: +7 927 606 19 83;
e-mail: belokonev63@yandex.ru,
Belokonev Vladimir I.
Belokonev Vladimir I., MD, Professor, Head of the Department of Surgical Diseases No2, Samara State Medical University, Samara, Russian Federation.
https://orcid.org/0000-0002-4625-6664
Pushkin Sergei Yu., MD,, Associate Professor, Professor of the Department of Surgical Diseases No2, Samara State Medical University, Samara, Russian Federation.
https://orcid.org/0000-0003-2206-6679
Kovaleva Zinaida V., PhD, Associate Professor of the Department of Surgical Diseases No2, Samara State Medical University, Samara, Russian Federation.
https://orcid.org/0000-0002-1810-7696
Avezova Diana B., Applicant of the Department of Surgical Diseases No2, Samara State Medical University, Samara, Russian Federation.
http://orcid.org/0000-0002-0813-8392
Novikov Denis V., Applicant of Surgical Diseases No2 Samara State Medical University, Samara, Russian Federation.
http://orcid.org/0000-0002-8194-4622
Article in the .pdf format
