Abstract
The aim of the work: based on the use of the program of multiparametric neural network clustering to analyze the results of examination and surgical treatment of patients with primary and postoperative ventral hernia in morbid obesity to identify a group of patients with high risk of complications in the postoperative period.
 Materials and Methods. A comprehensive clinical-instrumental and laboratory examination of 237 patients with primary ventral and postoperative ventral hernia with concomitant morbid obesity with subsequent assessment of the nature of complications in the early and late postoperative periods was conducted. Patients were examined according to standards with this nosology, including general clinical, detailed study of all organs and systems of the body and local status (location, size, length of hernial protrusion) according to the EHS classification (2009). In the postoperative period, early (prolonged lymphorrhea, seroma, hematoma, infiltrate, marginal necrosis of the skin, suppuration) and late (mesh migration, meshomas, intestinal and ligature fistulas, mesh rejection, chronic pain, hernia recurrence) local and general (abdominal compartment syndrome, pulmonary embolism, pneumonia, myocardial infarction) complications. Clustering of subjects by groups using the add-on NeuroXL Classifier for Microsoft Excel was conducted for more in-depth analysis and in order to predict the complications in the postoperative period
 Results and Discussion. Analysis of cluster pictures during neural clustering based on clinical and anamnestic data and types of surgical interventions revealed that in predicting the risk of complications in the postoperative period based on combined changes, the combination of sex, obesity II-III and respiratory failure when own tissue hernioplasty and Onlay in patients were the most important. It should also be noted that the identified pattern primarily relates to the development of complications such as acute cerebrovascular accident, seroma and marginal necrosis of the postoperative wound. The lowest complication rate was observed in obese patients during laparoscopic hernioplasty and eMILOS (mini/less open sublay).
Highlights
The aim of the work: based on the use of the program of multiparametric neural network clustering to analyze the results of examination and surgical treatment of patients with primary and postoperative ventral hernia in morbid obesity to identify a group of patients at high risk of complications in the postoperative period
In order to establish the value of combined changes in the studied indicators for effective prediction of complications, neural network clustering of the results of a comprehensive clinical history and laboratory studies was performed based on the following indicators: age, sex, blood type, comorbidity: Age – age (1), S – sex (2), Ob – obesity I, II, III (3), CPI – chronic obstructive pulmonary disease (4), HeF – heart failure (5), Diab – diabetes mellitus (6), NDS – undifferentiated connective tissue dysplasia (7), VD – varicose vein disease (8), protein (10), bilirubin (11), creatinine (12), urea (13), AST (14), ALT (15), types of surgeries performed and complications of postoperative period
Analysis of cluster pictures in neural network clustering based on clinical history and laboratory indicators and the rate of complications in the postoperative period revealed that in predicting the risk of complications in the postoperative period based on the combined changes in the anamnesis, the most significant are the combination of sex, respiratory failure and elevated levels of protein, total bilirubin, urea and AST in the operated patients
Summary
The aim of the work: based on the use of the program of multiparametric neural network clustering to analyze the results of examination and surgical treatment of patients with primary and postoperative ventral hernia in morbid obesity to identify a group of patients with high risk of complications in the postoperative period. A comprehensive clinical-instrumental and laboratory examination of 237 patients with primary ventral and postoperative ventral hernia with concomitant morbid obesity with subsequent assessment of the nature of complications in the early and late postoperative periods was conducted. The aim of the work: based on the use of the program of multiparametric neural network clustering to analyze the results of examination and surgical treatment of patients with primary and postoperative ventral hernia in morbid obesity to identify a group of patients at high risk of complications in the postoperative period
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