Features of surgical treatment of patients with postoperative ventral hernias, taking into account the degree of intra-abdominal hypertension caused by changes in the function of external respiration

Abstract

A study of the function of external respiration and intra-abdominal hypertension was carried out before, during and in the postoperative period in 170 patients with POVH who underwent combined methods of hernial gate repair using allografts. We have found that the absence of intra-abdominal hypertension or the presence of grade I IAH with intraoperative rapprochement of the aponeurosis edges is one of the factors to performing, for patients with POVH, tension methods of hernia gate plasty. A sharp increase of the IAH (II-IV grade) when the edges of the aponeurosis are brought together during surgery is accompanied by the development of symptoms of the abdominal compartment syndrome and is an indicator of the performing non-tension plastics' methods of POVH. In 9.4% of patients to which completed POVH plastic surgery by non-tension method, in the early postoperative period, intra-abdominal hypertension still persists within the boundaries of grade I IAH, which is due to the formation of a deficit in the volume of the abdominal cavity due to the presence of pronounced dystrophic changes in the tissues of the anterior abdominal wall and leads to partial loss of their functions to reduce and expand.