Application and progress of initiative content reduction surgery in the treatment of large ventral hernia

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Currently, the number of abdominal surgery has gradually increased, accompanied by the increasing of ventral hernia and parastomal hernia patients. The main reason is abdominal incision or abdominal stoma destroying the normal abdominal muscle fascia, as well as obesity, malnutrition, ascites, diabetes, infections leading to poor wound healing. The incidence of abdominal wall incisional hernia after abdominal surgery accounts for about 80% of ventral hernia. These incisional hernias and some other ventral hernias may easily become large ventral hernia without the standard treatment. Surgery is the only effective treatment for large ventral hernia. However, such hernia repair for surgeons is a great challenge. In clinical practice, after removing the huge sac and completely resetting the contents of the hernia sac can lead to decreasing of intraperitoneal volume and increasing of intra-abdominal pressure, or even lead to occurrence of abdominal compartment syndrome (ACS). The increasing of intra-abdominal pressure and occurrence of ACS has aroused the attention of clinicians after large ventral hernia operation. Some content reduction operation in the process of large ventral hernia surgery can effectively reduce postoperative intra-abdominal pressure, occurrence of intra-abdominal hypertension and ACS. More and more patients with large ventral hernia underwent the abdominal content reduction surgery combined with hernia repair. But there is still lack of evidence-based medical researches on large simples. Therefore, it still needs multi-center prospective clinical study on large samples to provide clinical treatment strategies for the volume reduction surgery and more base for further researches and clinical applications. Key words: Initiative content reduction; Large ventral hernia; Abdominal compartment syndrome; Intra-abdominal hypertension