CLINICAL FEATURES OF THE OCCURRENCE OF POSTOPERATIVE EVENTRATION ON THE BACKGROUND OF THE ONCOLOGICAL PROCESS

Abstract

At present, postoperative eventration is relatively rare, but it is one of the mostdangerous complications of abdominal surgery, which occurs in 0.5-2.35% of patients.The greatest risk group constitute patients with malignant neoplasms of the abdominalcavity organs, with manifestations of secondary immunodeficiency, cachexia, anemia,which certainly affects the rate of regeneration and the risk of purulent-septiccomplications development from the side of postoperative wounds.The study of the clinical features of PE (postoperative eventration) development againsta background of the oncological process will afford opportunity to understand betterthe role of the latter in the development of this postoperative complication.Purpose - to study the clinical features of postoperative eventration development inpatients with malignant neoplasms of the abdominal cavity organs.Material and research methods. 114 patients, operated on for various diseases of theabdominal cavity organs, who underwent postoperative eventration during the first 10days of the early postoperative period, have been examined.The main group consisted of 61 patients with malignant neoplasms of the abdominalcavity organs, in stages III-IV of the disease. The group of comparison consisted of 53patients with acute surgical non-oncological pathology of the abdominal cavity organs.Both groups of patients were representative by sex.All patients, during their stay in the hospital, received standard postoperative treatment,according to the protocols of medical care for patients with urgent surgical pathologyof the abdominal organs.Levels of intra-abdominal and abdominal perfusion pressure were determined atintervals of 3 times a day during the first 12 days of the early postoperative period.Statistical processing of the research results obtained was carried out on a personalcomputer using Microsoft Excel spreadsheets, as well as IBM SPSS Statistics (2012).Results. It has been established that postoperative eventration against a backgroundof the oncological process occurs in older patients. Postoperative eventration againsta background of the oncological process is characterized by a shorter period of itsdevelopment, and is dominated by III and IV degrees of its severity, that requiresimmediate surgical intervention, thereby worsening the treatment results of theunderlying disease.This postoperative eventration occurs more often when performing medium andcomplete laparotomies, and also directly depends on the size of the latter.Peculiarities of the influence of intra-abdominal and abdominal perfusion pressures onthe development of postoperative eventration against a background of the oncologicalprocess and without it do not differ, as there is no probable difference in all degrees ofseverity.It should be noted that postoperative eventration against a background of theoncological process occurs in patients with concomitant chronic pathology, deficit ofthe body weight or normal weight.Postoperative mortality in the main group of patients occurred in 32 (52.5%) people,that is 16.7% (p> 0.05) higher than in the comparison group - 19 (35.8%) people.Conclusions. Postoperative eventration against a background of the oncologicalprocess occurs mainly in average middle or complete laparotomies, in older patients,with chronic concomitant pathology and deficiency of the body weight or normal weight.This postoperative eventration is characterized by the prevalence of III-IV degrees ofseverity, shorter development period, and higher frequency of postoperative mortality.