Опыт применения симультанных операций у больных с варикозной болезнью и грыжами передней брюшной стенки

Abstract

Aim: to substantiate the feasibility of concurrent surgeries in patients with varicose vein disease and anterior abdominal wall hernias (ventral hernias). Patients and Methods: the paper presents the treatment results of 82 patients with ventrial hernias and lower limb varicose vein disease. The method choice and the scope of surgical intervention were determined on the basis of clinical and instrumental examination data. Commonly, Lichtenstein tension-free hernia repair in combination with crossectomy, endovasal laser coagulation (EVLC), varicose veins radiofrequency ablation (VVRFA) were performed. The long-term results were analyzed 1–2 years after the use of concurrent surgeries. The life quality before surgery and a year after was determined by the SF-36 questionnaire. Results: the patients consisted of 45 (54.9%) men and 37 (45.1%) women aged 19 to 69 years. In 20 (24.4%) of the admitted patients, work was associated with physical activity, and 56 (68.3%) patients were at the most capable age: 19 to 50 years. Upon admission to the clinic, 78 patients had complaints. Commonly, they had a combination of varicose vein disease with inguinal or umbilical hernias. After the use of concurrent surgeries, no specific complications were observed in this patient cohort, as well as complications associated with both diseases concomitantly. In the long-term period, patients noted an improvement in their general health by 23.2%. In the preoperative period, the indicator of physical functioning was 41.27 points; after the operation, there was an increase in this indicator according to patients’ estimates by 1.6 times — to 67.32 points. After surgery, the greatest positive trend of vital activity (42.8%) and role limitations due to emotional state (57.3%) were observed. There was an increase in all indicators of life quality by 18.2–53.9% in patients who underwent concurrent surgeries. Conclusion: the obtained results demonstrated the safety and high efficacy of concurrent surgeries in patients with varicose vein disease and ventral hernias. Thus, the use of concurrent surgeries is considered to be an alternative to the staged treatment of patients with varicose vein disease and ventral hernias KEYWORDS: concurrent surgeries, varicose vein disease, ventral hernias, life quality, postoperative complications. FOR CITATION: Chernookov A.I., Kuznetsov M.R., Kandyba S.I. et al. Concurrent surgeries in patients with varicose vein disease and ventral hernias. Russian Medical Inquiry. 2022;6(4):164–170 (in Russ.). DOI: 10.32364/2587-6821-2022-6-4-164-1.