Long-Term Outcomes and the Quality of Life in Patients with Postoperative Ventral Hernias after Various Surgical Options

Abstract

Introduction. Clinical outcomes of surgical treatment of postoperative ventral hernias are to be investigated not only in the nearest but also in the long-term postoperative period. The aim of research was to study the effectiveness of various methods of hernioplasty and the patients' quality of life in the long-term surgical treatment of postoperative ventral hernias.Materials and methods. The authors analyzed the results of surgical treatment of 76 patients with postoperative ventral hernias in the late postoperative period after various methods of hernioplasty during 2006-2017. The average term of follow up examination was 5.7 years. The patients quality of life was assessed using the SF-36 questionnaire; the anterior abdominal wall and the surgical area examination was performed in all patients; the patients were interviewed on adherence to recommendations in the postoperative period. Results. The average physical health index (PH) was 47,271,05, while mental health index (MH) was 52,861,04. These parameters were low due to the age of the patients (60, 231,29 old), as well as the presence of concomitant diseases of the cardiovascular system (80,3%) and obesity (75%). Index of physical health component in sublay and corrective plastics was significantly lower than in autoplastic and onlay disposition of the prosthesis (р0,001). However, the onlay method as well as the corrective technique and autoplasty revealed a high risk of hernia recurrence, and as a result, a decrease in physical and mental health indexes. According to the survey, it was found that more than 50% of the patients did not adhere to the recommendations for restricting physical exertion and wearing a bandage, which also contributed to the hernia recurrence. In 28% of patients reherniation or diastasis recti abdominis was detected in the surgical area. However, the patients did not notice these changes or did not believe in the success of repeated interventions. Conclusion. Thus, the sublay technique proved to be a preferred method of various hernioplasty options. However, a search for more functional prostheses is needed to improve the quality of patients life. To prevent reherniation, patients are strongly recommended to adhere to the terms of wearing the bandage and restricting physical activity. Follow-up examinations of the patients should be performed by healthcare providers to timely reveal and treat recurrent postoperative ventral hernias.