Outcomes of surgical treatment of obese patients with ventral and incisional hernias

ABSTRACT

Introduction. The results of the surgical treatment of ventral and incision hernias in the obese patients are poor, because of the high incidence of complications and relapses.

The objective of the study was to analyse the outcomes of patients with hernias, obesity and non-specific connective tissue dysplasia (NSCTD), and to define the main predictors of complications development.

Methods. We analysed the outcomes of treatment in 1133 patients, who underwent surgery for primary and incision ventral hernia between 2006-2017.

Results. Pulmonary embolism was diagnosed in 0.62% of the patients, abdominal compartment syndrome (ACS) in 3.0% of the individuals, after stretching hernioplasty. The highest incidence of wound complications was evidenced in patients with stage 3 obesity – 35.14%. The signs of NSCTD were present in 53.45% of the patients with recurrent hernia, and in 18.61% of the patients with no recurrence of hernia. In patients with obesity stage 1 and 2, the development of ACS depended only on the chosen method of surgical intervention. In patients with no recurrent hernia, the division of patients according to their blood groups did not significantly differ from the general population.

Conclusions. The non-stretching methods of hernioplasty should be a priority, especially for patients with morbid obesity, stage 2-3, and significant comorbidity. The risk group for relapses also includes the patients with NSCTD and A(2) blood group, since the incidence of NSCTD in these individuals is statistically significantly higher.

Keywords: ventral hernia, incision hernia, morbid obesity, non-specific connective tissue dysplasia, complications.

Corresponding author:
Volodymyr I. PIATNOCHKA
Department of Surgery of the Academic and Research Institute of Postgraduate Education, I. Horbachevsky Ternopil State Medical University, Ukraine
Address: 1 Maidan Voli, Ternopil, 46001, Ukraine
E-mail: vladymyrpiatnochka@gmail.com; Phone number +380677361937