New approach to treatment of ventral hernias of the medial localization

Abstract

Importance. Functional results of treatment of the ventral hernias of the medial localization after endoprosthetics of the abdominal wall by the standard polypropylene prosthesis remain unsatisfactory because of the limited flexibility of the abdominal wall.
 Purpose. To improve functional results of treatment of patients with ventral hernias of the medial localization by applying a light strengthened endoprosthesis.
 Materials and methods. There was done a comparative analysis of the results of treatment of 60 patients with medial hernias of the anterior abdominal wall. Patients were divided into two groups with 30 people in each group. In the first group over-aponeurotic endoprosthetics of the abdominal wall defect was provided with the use of a standard polypropylene prosthesis with the thread diameter 120 micron, while in the second group there was used a light strengthened endoprosthesis with the thread diameter in the basic zones 90 micron and in the strengthened zones 120 and 90 micron. Effectiveness of treatment in the nearest post-operative period was evaluated by the degree of severity of inflammatory implantation response, and in the long-term period evaluation was done on the base of functional state of the abdominal muscles, quality of life of patients and results of treatment by four point scale. 
 Results and their discussion. Inflammatory exudative response on implantation of the light strengthened endoprosthesis was less and reparative response was 1,1 times higher compare to a standard prosthesis. Endoprosthetics of the abdominal wall with a light strengthened endoprosthesis improved contractility of the abdominal muscles in 1,2 times. Restoration of the functions of the abdominal muscles had a positive influence on quality of life, namely, physical component of health improved by 4,5%, as well as on long-term results of treatment by the increased number of excellent and good results of treatment by 20% and reduction of satisfactory results by 20%.
 Conclusions. The use of a light strengthened endoprosthesis enables to improve the functional results of treatment of ventral hernias of the medial localization.