Abstract
Introduction. Complex incisional hernias are a surgical challenge and a current socio-economic problem. In the emergency surgery of this pathology, the surgeon faces the need to obtain a "tension-free" hernia repair being limited in the use of parietal prosthesis due to the frequent needs of opening the gastrointestinal tract and thus contamination of the operating field. Purpose. The aim of this study is to evaluate and adapt emergency surgical treatment in order to reduce the risk of postoperative complications. Material and methods. The present study has a retrospective character and evaluates a group of 390 patients with complex incisional hernias admitted and operated in the General and Emergency Surgery III section of the Bucharest University Emergency Hospital during 2008-2018. Results. We identified 390 patients diagnosed with complex incisional hernias, of whom 95 were presented to the hospital as an emergency.The prosthetic hernioraphy was used in 51 of these patients, and complications were found in 18 patients in the total study group, ranging from wound infection to death. Discussions. The occurrence of postoperative complications was not statistically significantly associated with emergency surgical treatment. Instead, vital complications were much more common in this group. Conclusions. Increasing the degree of information and education of the patient, increasing addressability and avoiding emergency operations for this pathology are long-term objectives in the treatment of complex incisional hernia pathology.
Highlights
Complex incisional hernias are a surgical challenge and a current socio-economic problem
The occurrence of postoperative complications was not statistically significantly associated with emergency surgical treatment
Complicaţiile postoperatorii au fost regăsite la 18,1% dintre pacienţii operaţi în urgenţă (9,58% dintre pacienţii operaţi tisular şi 8,52 dintre pacienţii la care au fost utilizate materialele protetice) [21], într-o proporţie mai scăzută comparativ cu 23,6% în studiile din literatură [7,14,17,19,28]
Summary
Simptomatologia ocluzivă intestinală, mergând până la oprirea definitivă a tranzitului intestinal, a fost unul dintre principalele motive care au determinat bolnavii ce prezentau defecte herniare postincizionale complexe să se prezinte la spital. Această simptomatologie a fost întâlnită la 77,7% dintre pacienţii operaţi în urgenţă, fapt relevant din punct de vedere statistic (p = 0,0001). Distribuţia şi corelaţia distribuţiei simptomatologiei ocluzive la prezentarea în urgenţă
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