TENSIONED HERNIOPLASTY AND ABDOMINOPLASTY IN PATIENTS WITH MORBIDE OBESITY

Abdurakhmanov D.Sh., Mardonov B.А., Davlatov S.S., Abduraimov Z.А.

Email: Abdurakhmanov6106@scientifictext.ru

Abdurakhmanov Diyor Shukurullaevich – Assistant;

Mardonov Bobosher Amirovich - Candidate of Medical Sciences, Assistant,

SAMARKAND STATE MEDICAL INSTITUTE,

SAMARKAND;

Davlatov Salim Sulaymonovich - Candidate of Medical Sciences, Associate Professor;

Abduraimov Zafarjon Abduraimovich – Assistant;

BUKHARA STATE MEDICAL INSTITUTE,

BUKHARA,

REPUBLIC OF UZBEKISTAN

Abstract: surgical treatment of hernias of the anterior abdominal wall remains an urgent problem, since hernia-bearing occurs in 4-7% of the world's population and there is no tendency to reduce the number of such patients. The aim of the study is to conduct a comparative analysis of traditional and non-tight methods of hernioplasty with hernias of the anterior abdominal wall, improve hernioplasty methods, the frequency of relapses and complications in the near and long-term postoperative periods.

The problem associated with overweight has existed for a very long time, but nevertheless, advances in the treatment of obesity are very small and the number of patients with morbid obesity is growing. According to the WHO, over 30% of the world's population suffers from overweight. All factors causing excess body weight lead to a weakening of the muscular aponeurotic framework with subsequent formation of abdominal ptosis. For plastic surgery of the anterior abdominal wall in modern surgery in patients with morbid obesity, non-tensioning methods are more preferable, since according to the studies of many authors with stretch hernioplasty, the recurrence rate reaches 20-63%, while in non- tension plastic surgery it is 8-30.3%.

The material of this study was 62 patients with morbid obesity who were hospitalized in the period from 2010 to 2019 in the surgical department No. 2 of the Republican Clinical Hospital in Nalchik on the basis of Hospital Surgery of KBSU. In our work, all patients had ptosis of the anterior abdominal wall of III (n = 44) and IV (n = 18) degrees of obesity. The patient underwent surgery to eliminate the skin-fat apron and non-tension abdominoplasty using a polypropylene mesh, in the presence of cholelithiasis, a cholecystectomy was performed.

As the results of the study showed, in 38.5% of patients there were some complications of an inflammatory nature, with somewhat more complications such as seromas, lymphorrhea and, as a result, purulent-inflammatory complications. This is due to the fact that patients underwent abdominoplasty in which a wide mobilization of the subcutaneous fat layer is performed and, accordingly, the risk of developing seromas and lymphorrhea is increased. Patients were hospitalized from 16 to 28 days.All patients were discharged in satisfactory condition with recommendations. In terms of the functional effect, due to the optimal scheme of preoperative preparation and abdominoplasty, an improvement in external respiration was noted, and there were no complications from the cardiovascular system. All patients were satisfied with the obtained aesthetic result.

Keywords: classical transverse abdominoplasty, non-tension hernioplasty, diastasis of the rectus abdominis muscles, umbilical ring hernias, giant hernias, morbid obesity.

НЕНАТЯЖНАЯ ГЕРНИОПЛАСТИКА И АБДОМИНОПЛАСТИКА У ПАЦИЕНТОВ С МОРБИДНЫМ ОЖИРЕНИЕМ

Абдурахманов Д.Ш., Мардонов Б.А., Давлатов С.С., Абдураимов З.А.

Абдурахманов Диёр Шукуруллаевич - ассистент;

Мардонов Бобошер Амирович - кандидат медицинских наук, ассистент,

Самаркандский государственный медицинский институт,

г. Самарканд;

Давлатов Салим Сулаймонович - кандидат медицинских наук, доцент;

Абдураимов Зафаржон Абдураимович – ассистент,

Бухарский государственный медицинский институт,

г. Бухара,

Республика Узбекистан

Аннотация: хирургическое лечение грыж передней брюшной стенки остается актуальной проблемой, так как грыженосительство встречается у 4-7% населения Земли и тенденции к снижению количества таких больных не отмечается. Целью исследования является проведение сравнительного анализа традиционных и ненатяжных методик герниопластики при грыжах передней брюшной стенки, совершенствование методов герниопластики, снижение частоты рецидивов и осложнений в ближайшем и отдаленном послеоперационных периодах.

Проблема, связанная с избыточной массой тела, существует очень давно, но тем не менее успехи по лечению ожирения очень малы, и все больше растет количество больных с морбидным ожирением. По данным ВОЗ избыточной массой тела страдают около 30 % всего населения Земли. Все факторы, вызывающие избыточную массу тела, приводят к ослаблению мышечно-апоневротического каркаса с последующим формированием птоза живота. Для пластики передней брюшной стенки у пациентов с морбидным ожирением в современной хирургии более предпочтительны ненатяжные методики, так как по исследованиям многих авторов при натяжной герниопластике частота рецидива достигает 20-63%, в то время как при ненатяжной пластике 8-30,3%.

Материалом данного исследования стали 62 больных с морбидным ожирением, находившиеся на стационарном лечении в период с 2010 по 2019 гг. в хирургическом отделении № 2 Республиканской клинической больницы г. Нальчика на базе Госпитальной хирургии КБГУ. В нашей работе все больные имели птоз передней брюшной стенки III (n=44) и IV (n=18) степени ожирения. Больным выполнены операции по ликвидации кожно-жирового фартука и ненатяжная абдоминопластика с использованием полипропиленовой сетки, при наличии ЖКБ производилась холецистэктомия.

Как показали результаты исследования, у 38,5% больных имели место те или иные осложнения воспалительного характера. Чаще имели место такие осложнения, как серомы и лимфорея, приводящие впоследствии к гнойно-воспалительным осложнениям. Это объясняется тем, что при выполнении абдоминопластики производится широкая мобилизация подкожно-жирового слоя, что существенно повышает риск развития сером и лимфореи. Больные находились на стационарном лечении от 16 до 28 дней. Все больные выписаны в удовлетворительном состоянии с рекомендациями. В аспекте функционального эффекта, благодаря оптимальной схеме предоперационной подготовки, выполнения абдоминопластики, отмечалось улучшение показателей внешнего дыхания, а осложнений со стороны сердечно-сосудистой системы не было. Все больные остались довольными полученным эстетическим результатом.

Ключевые слова: классическая поперечная абдоминопластика, ненатяжная герниопластика, диастаз прямых мышц живота, грыжи пупочного кольца, гигантские грыжи, морбидное ожирение.

References / Список литературы

Azamat S., Salim D. Factors influencing the choice of hernia repair method in patients with incisional hernias //European science review, 2017. № 1-2.
Shamsiyev А. and Davlatov S. "Factors influencing the choice of hernia repair method in patients with incisional hernias". European science review. 1-2 (2017).
Azamat S. & Salim D. (2017). Factors influencing the choice of hernia repair method in patients with incisional hernias. European science review (1-2).
Davlatov Salim and Abdusattarova Sarvinoz. Hernioabdominoplastics of postoperative ventral hernia in patients with obesity //International scientific review, 2016. № 11 (21).
Davlatov Salim and Abdusattarova Sarvinoz. "Hernioabdominoplastics of postoperative ventral hernia in patients with obesity." International scientific review. 11 (21) (2016).
Davlatov Salim and Abdusattarova Sarvinoz (2016). Hernioabdominoplastics of postoperative ventral hernia in patients with obesity. International scientific review, (11 (21)).
Davlatov Salim and Abdusattarova Sarvinoz Criteria’s of choice method in surgical treatment of patients ventral hernia with concomitant obesity // European research, 2016. № 7 (18).
Davlatov Salim, and Abdusattarova Sarvinoz. "Criteria’s of choice method in surgical treatment of patients ventral hernia with concomitant obesity". European research. 7 (18) (2016).
Davlatov Salim and Abdusattarova Sarvinoz (2016). Criteria’s of choice method in surgical treatment of patients ventral hernia with concomitant obesity. European research, 7 (18).
Amirovich M.B., Zafarovich S.J. Modern problems and perspective of treatment of patients with ventral hernia with simultaneous pathologies // Scientific research, 2018. № 4 (23).
Mardonov В.A. and Shamsiev Jasur Zafarovich. "Modern problems and perspective of treatment of patients with ventral hernia with simultaneous pathologies". Scientific research. 4 (23) (2018).
Amirovich M.B. & Zafarovich S.J. (2018). Modern problems and perspective of treatment of patients with ventral hernia with simultaneous pathologies. Scientific research. 4 (23).
Davlatov S.S., Abdusattarova S.K. Criteria's of choice method in surgical treatment of patients ventral hernia with concomitant obesity Davlatov S., Abdusattarova S. Criteria for choosing a method of surgical treatment of patients with ventral hernia with concomitant obesity // European research: innovation in science, education and technology, 2016. Р. 84.
Davlatov S.S. and Abdusattarova S.K. "Criteria's of choice method in surgical treatment of patients ventral hernia with concomitant obesity Davlatov S., Abdusattarova S. Criteria for the choice of surgical treatment of patients with ventral hernia with concomitant obesity." European research: innovation in science, education and technology, 2016. 84.
Davlatov S.S. & Abdusattarova S.K. Criteria's of choice method in surgical treatment of patients ventral hernia with concomitant obesity Davlatov S., Abdusattarova S. Criteria for choosing a method of surgical treatment of patients with ventral hernia with concomitant obesity. European research: innovation in science, education and technology, 2016. 84.
Mardonov B.A. et al. Clinical and instrumental characteristics of postoperative ventral hernias in choosing the optimal method of plastic surgery // Achievements of science and education, 2020. № 1 (55).
Mardonov Bobosher Amirovich et al. "Clinical and instrumental characteristics of postoperative ventral hernias in choosing the optimal method of plastic surgery." Achievements of science and education. 1 (55) (2020).
Mardonov B.A., Isakov A.M., Bakhriev B.L. & Kurbaniyazova A.Z. (2020). Clinical and instrumental characteristics of postoperative ventral hernias in the choice of the optimal method of plastic surgery. Achievements of science and education. 1 (55).
Rakhmanov K.E., Davlatov S.S. Diagnosis and treatment of mirizzi syndrome // Questions of science and education, 2020. № 13 (97).
Rakhmanov Мowing Aganovich and Davlatov Salim Sulaymonovich. "Diagnosis and treatment of mirizzi syndrome." Issues of science and education. 13 (97) (2020).
Rakhmanov K.E. & Davlatov S.S. (2020). Diagnosis and treatment of mirizzi syndrome. Issues of science and education. 13 (97).
Erdanovich R.K., Sulaymonovich D.S., Chorievich M.M. Modern methods of surgical treatment of varicocele (literature review), 2020. № 23-2 (101).
Erdanovich, Rakhmanov Kosim, Davlatov Salim Sulaymonovich and Mamanov Mukhammad Chorievich. "Modern methods of surgical treatment of varicocele (literature review)." Bulletin of Science and Education 23-2 (101) (2020).
Erdanovich R.K., Sulaymonovich D.S. & Chorievich M.M. (2020). Modern methods of surgical treatment of varicocele (literature review). Bulletin of Science and Education, 23-2 (101).
Davlatov S.S., Khidirov Z.E., Nasimov A.M. Differentiated approach to the treatment of patients with Mirizzi syndrome, 2017. № 2 (17).
Davlatov Salim Sulaymonovich, Hidirov Sadulla Erkinovich and Nasimov Abdujalil Mamayunusov. "Differentiated approach to the treatment of patients with mirizzi syndrome". Academy. 2 (17) (2017).
Salim D., Sarvinoz A. Hernioabdominoplastics of postoperative ventral hernia in patients with obesity // International scientific review, 2016. № 11 (21).
Davlatov Salim and Abdusattarova Sarvinoz. "Hernioabdominoplastics of postoperative ventral hernia in patients with obesity." International scientific review. 11 (21) (2016).
Salim D. & Sarvinoz A. (2016). Hernioabdominoplastics of postoperative ventral hernia in patients with obesity. International scientific review, (11 (21))
Davlatov S.S., Khidirov Z.E. & Nasimov A.M. (2017). Differentiated approach to the treatment of patients with Mirizzi syndrome. Academy. 2 (17).
Rizaev Zh.A., Khazratov A.I. Carcinogenic effect of 1, 2-dimethylhydrazine on the body as a whole, 2020. № 1. Р. 116.
Rizaev Jasur A. and Isamiddinova Alisher of Hasraton. "Carcinogenic effect of 1, 2-dimethylhydrazine on the body as a whole". Biology. 1 (2020): 116.
Rizaev Zh.A. & Khazratov A.I. (2020). Carcinogenic effect of 1, 2-dimethylhydrazine on the body as a whole. Biologiya (1), 116.
Rizaev J.A., Maeda H., Khramova N.V. Plastic surgery for the defects in maxillofacial region after surgical resection of benign tumors / / Annals of Cancer Research and Therapy, 2019. Vol. 27. № Рp. 22-23.
Rizaev Jasur A., Hiromichi Maeda and Khramova Natalya V.. "Plastic surgery for the defects in maxillofacial region after surgical resection of benign tumors." Annals of Cancer Research and Therapy 27.1 (2019): 22-23.
Rizaev J.A., Maeda H. & Khramova N.V. (2019). Plastic surgery for the defects in maxillofacial region after surgical resection of benign tumors. Annals of Cancer Research and Therapy. 27(1). 22-23.

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Электронная версия. Abdurakhmanov D.Sh., Mardonov B.А., Davlatov S.S., Abduraimov Z.А. TENSIONED HERNIOPLASTY AND ABDOMINOPLASTY IN PATIENTS WITH MORBIDE OBESITY // Вестник науки и образования № 3(106), 2021 [Электронныйресурс].URL: http://scientificjournal.ru/images/PDF/2021/106/tensioned-hernioplasty-an.pdf (Дата обращения:ХХ.ХХ.201Х).

Печатная версия. Abdurakhmanov D.Sh., Mardonov B.А., Davlatov S.S., Abduraimov Z.А. TENSIONED HERNIOPLASTY AND ABDOMINOPLASTY IN PATIENTS WITH MORBIDE OBESITY // Вестник науки и образования № 3(106), 2021, C. {см. журнал}.