Evaluating the results of surgical treatment and quality of life in patients with postoperative ventral hernia and concomitant obesity after different types of hernioplasty

Abstract

Background. The problem of improving the quality of life of patients after surgical treatment of ventral hernias is very relevant, which is explained by the growing number of persons with this pathology, a high rate of relapses and complications when performing reconstructive surgical interventions (4.3–46 %) in this category of patients. The purpose of the research was to study the long-term results of surgical treatment of patients with cicatricial hernia of the anterior abdominal wall in obesity (late postoperative complications and quality of life), to perform a comparative evaluation of results in groups of patients operated by traditional methods using polypropylene mesh and allohernioplasty in combination with dermatolipectomy. Materials and methods. 108 patients were operated for postoperative ventral hernia. The first group consisted of patients who, according to their personal beliefs, refused to use the mesh, therefore, they underwent surgical procedures in traditional ways, the second group of patients underwent only allohernioplasty. In the third group of patients, allohernioplasty was supplemented by the simultaneous dermatolipectomy. We studied late postoperative complications (recurrences of hernias in a period of up to 3 years) and the quality of life of patients. Results. According to the received data, it can be asserted that the incidence of late postoperative complications in patients who underwent surgery for postoperative ventral hernia with the use of prosthetic plasty, especially in combination with dermatolipectomy, is significantly lower than the indices of the group operated by traditional methods. A decrease in body weight was noted in the majority of patients who underwent prosthetic hernioplasty. The analysis of the received data on the basic criteria of the quality of life assessment has shown that in the majority of patients with hernioplasty concerning primary ventral and cicatricial hernias by traditional classical ways it was low. Conclusions. The quality of life in most patients after prosthetic hernioplasty was high. The analysis of the incidence of late postoperative complications makes it possible to distinguish the advantages of performing prosthetic hernioplasty in comparison with traditional autoplastic methods. We consider this technique as an operation of choice in patients with postoperative ventral hernia in the presence of concomitant obesity.