Open AccessCHOOSING A METHOD OF SURGICAL TREATMENT OF PARAKNOLOSTOMY HERNIAS IN PATIENTS WITH OBESITY
Author(s) -
О. О. Vorovskiy,
Volodymyr Shaprinskiy,
E. V. Shaprinskiy,
I. M. Sadik
Publication year - 2020
Publication title -
harkìvsʹka hìrurgìčna škola
Language(s) - English
Resource type - Journals
ISSN - 2308-7005
DOI - 10.37699/2308-7005.2.2020.29
Subject(s) - medicine , surgery , pneumoperitoneum , concomitant , hernia , laparoscopy , colostomy , diabetes mellitus , obesity , general surgery , endocrinology
Smmary. The aim of the work was to solve the problem of preventing and choosing the method of surgical treatment of paracolostomy hernia in patients with obesity.
Materials and research methods. The treatment results of 56 (100.0 %) patients with obesity operated on for paracolostomy hernia were analyzed. Men made up 27 (56.2 %) people, women - 29 (29.0 %). In all patients of this age category, except for obesity, there was a combined concomitant pathology: atherosclerotic and post-infarction cardiosclerosis — in 56 (100.0 %) cases; COPD - in 42 (69.6 %); diabetes mellitus — in 18 (26.1 %); cerebrosclerosis — in 17 (24.6 %). Surgical treatment of paracolostomy hernias was performed by 3 methods: alloernioplasty with colostomy left in the same place was performed in 16 (29.0 %) patients; allohernioplasty with colostomy moving to a new place — 22 (52.2 %) patients; 18 (18.2 %) used minimally invasive methods, of which 8 (11.6 %) using the laparoscopically-assisted method. The average duration of laparoscopic hernioplasty was (65.5 ± 5.5) minutes., With «open» methods — (45.5 ± 5.5) minutes
Research results. The analysis of the results of treatment of paracolostomy hernias with three different methods was carried out; the groups were identical in terms of the number of patients. According to the duration of the operation, the laparoscopic method of alloernioplasty was longer and needed the use of general anesthesia and pneumoperitoneum, which can cause the development of a number of dangerous complications. The other two extraperitoneal methods of allogeneioplasty are more gentle, can be performed under spinal or epidural anesthesia. However, it is precisely with these methods of alogioplasty that the risk of developing local complications is high.
Conclusions. In the treatment of paracolonostomy hernias in patients with obesity, the best results were obtained with laparoscopic alloernioplasty. When withdrawing a colostomy in patients of advanced and senile age, preventive alloprosthetics are recommended.