Analysis of the effectiveness of selected methods of anterior abdominal wall plasty in ventral hernia

Objective. To evaluate the effectiveness of surgical treatment of patients with anterior abdominal wall hernias after the sublay hernioplasty technique, as well as with the developed method of alloplasty and hernioplastics with polypropylene mesh treated with platelet-rich plasma (PRP).

Materials and methods. The study included 98 patients with incisional and primary ventral hernias: Group 1 — 37 patients operated in 2013—2015 using the sublay method; Group 2 — 30 patients operated on in 2016 — 2019 using hernioplasty according to the developed method; Group 3 — 31 patients with primary and incisional ventral hernias repaired with polypropylene mesh treated with PRP.

Results. Surgical treatment of postoperative ventral hernias using sublay polypropylene mesh repair is associated with local complications in 10.8 % of cases. Recurrent hernias were reported in 17.2 % of cases. In the long-term postoperative period, 34.5 % of patients had pain syndrome: pain at rest in 10.3% of patients, and pain during physical activity — in 24.2

% of patients.

The developed method of the anterior abdominal wall plastics reduces the rate of postoperative complications from 10.8 % to 3.3 %. Pain syndrome in the long-term postoperative follow-up was reported in 21.7 % of patients, and no recurrences during the follow-up observation period (4 to 7 years) were reported.

Hernioplasty with polypropylene mesh treated with PRP allowed reduction in the rate of early postoperative complications from 10.8 to 5.4 % and reduces the in-hospital stay by 22.4 % (from 8.5 to 6.6 days).

Conclusion. The surgical method of sublay ventral hernia repair is associated with relapses and pain in the long-term follow-up period, which encourages the search for ways to improve treatment outcomes. The developed method of hernioplasty with polypropylene mesh, as well as with PRP-treated mesh, allows to increase the effectiveness of surgical treatment of ventral hernias.

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