P-119 A MODIFIED CHEVREL AS AN ALTERNATIVE WALL CLOSURE TECHNIQUE FOR PATIENTS WITH ABDOMINAL HYPERTENSION

Abstract

Abstract Abdominal compartment syndrome is a pontentially life-threatening condition seen in critically ill patients, and most often caused by acute pancreatitis, postoperative abdominal vacular thrombosis or mesenteric ischemia. A descompressive laparotomy is sometimes required, often resulting in hernias, and subsequent definitive wall closure is challenging. Aim This study aims to describe short term results after a modified Chevrel technique for midline incisional repair in patients witch abdominal hypertension. Materials & Methods We performed a modified Chevrel as an abdominal closure technique in 9 patients between January 2016 and January 2022. All patients presented varying degrees of abdominal hypertension. Results Nine patients were treated with new technique (6 male and 3 female), all of whom had conditions that precluded unfolding the contralateral side as a means for closure. The reasons for this were diverse, including presence of ileostomies, intra-abdominal drainages, Kher tubes or an inverted T scar from previous transplant. The use of mesh was initially dismissed in 6 of the patients (66.7%) because they required subsequent abdominal surgeries. None of the patients developed a hernia, although two died 6 months after the procedure. Only one patient developed buldging. A decrease in intrabdominal pressure was achieved in all patients. Conclusion The modified Chevrel technique can be used as a closure option for midline ventral hernias in cases where the entire abdominal wall cannot be used.