OPTIMIZATION OF SURGICAL TREATMENT OF PATIENTS WITH RECTUS ABDOMINIS DIASTASIS

K. L. Gaft, V. V. Tsiliurik
{"title":"OPTIMIZATION OF SURGICAL TREATMENT OF PATIENTS WITH RECTUS ABDOMINIS DIASTASIS","authors":"K. L. Gaft, V. V. Tsiliurik","doi":"10.37699/2308-7005.1-2.2023.04","DOIUrl":null,"url":null,"abstract":"Summary. Introduction. The experience of treating 88 patients with rectus abdominis diastasis and rectus abdominis diastasis in combination with anterior abdominal wall hernias is presented. The effectiveness of various types of laparoscopic and traditional surgical interventions have been studied. \nAim. Optimization of surgical treatment of patients with rectus abdominis diastasis by developing and implementing new various types of laparoscopic interventions. \nMaterials and methods. All 88 patients were divided into 2 groups. The main group consisted of 43 patients (26 women and 17 men), the comparison group – 45 (19 men and 26 women). In the comparison group, patients underwent surgical interventions using traditional methods: autoplasty according to Sapezhko – 2; Autoplasty according to Napalkov – 10; Alloplasty according to the “inlay” type – 23; Allogernioplasty according to the “Subllay” type – 10. In the main group, patients underwent surgical interventions using purely laparoscopic methods in the volume: rectomuscularography according to the “Total Endoclose” type – 7; operation “ Irom “with fixation of the prosthesis according to the type” Total Ergoclose” – 20; operation “Irom “+ rectomuscularography with fixation of the prosthesis according to the type “Total Ergoclose” – 13; operation “E-TEP”according to the river-Stoppa method with fixation of the prosthesis according to the type” Total Ergoclose” – 1. \nResearch results and their discussion. The effectiveness of operations was evaluated basing on the quality and rate of formation of muscle duplication, or reticular-fibrous complex on the site of diastasis, by measuring the thickness of the anterior abdominal wall using ultrasound at three levels: in the epigastric zone – approximately 7 cm. above the navel, or along the upper edge of the mesh graft fixation; 2 cm above the navel, or along the conditional center of the mesh graft; 2 cm below the navel, or along the lower edge of the mesh graft fixation. Studies in each zone were performed three times: on the 5th day, 1 month later, and 6 months after surgery. \nConclusions. The formation of a mesh-fibrous complex, or muscle duplication, during open operations lasts much longer than during laparoscopic interventions. In the main group, a month later, ultrasound data shows almost complete restoration of the natural anatomy of the abdominal wall, and 6 months after surgery, the difference between the thickness of the anterior abdominal wall in the main group and the comparison group is 3 times.","PeriodicalId":405037,"journal":{"name":"Kharkiv Surgical School","volume":"65 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Kharkiv Surgical School","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.37699/2308-7005.1-2.2023.04","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Summary. Introduction. The experience of treating 88 patients with rectus abdominis diastasis and rectus abdominis diastasis in combination with anterior abdominal wall hernias is presented. The effectiveness of various types of laparoscopic and traditional surgical interventions have been studied. Aim. Optimization of surgical treatment of patients with rectus abdominis diastasis by developing and implementing new various types of laparoscopic interventions. Materials and methods. All 88 patients were divided into 2 groups. The main group consisted of 43 patients (26 women and 17 men), the comparison group – 45 (19 men and 26 women). In the comparison group, patients underwent surgical interventions using traditional methods: autoplasty according to Sapezhko – 2; Autoplasty according to Napalkov – 10; Alloplasty according to the “inlay” type – 23; Allogernioplasty according to the “Subllay” type – 10. In the main group, patients underwent surgical interventions using purely laparoscopic methods in the volume: rectomuscularography according to the “Total Endoclose” type – 7; operation “ Irom “with fixation of the prosthesis according to the type” Total Ergoclose” – 20; operation “Irom “+ rectomuscularography with fixation of the prosthesis according to the type “Total Ergoclose” – 13; operation “E-TEP”according to the river-Stoppa method with fixation of the prosthesis according to the type” Total Ergoclose” – 1. Research results and their discussion. The effectiveness of operations was evaluated basing on the quality and rate of formation of muscle duplication, or reticular-fibrous complex on the site of diastasis, by measuring the thickness of the anterior abdominal wall using ultrasound at three levels: in the epigastric zone – approximately 7 cm. above the navel, or along the upper edge of the mesh graft fixation; 2 cm above the navel, or along the conditional center of the mesh graft; 2 cm below the navel, or along the lower edge of the mesh graft fixation. Studies in each zone were performed three times: on the 5th day, 1 month later, and 6 months after surgery. Conclusions. The formation of a mesh-fibrous complex, or muscle duplication, during open operations lasts much longer than during laparoscopic interventions. In the main group, a month later, ultrasound data shows almost complete restoration of the natural anatomy of the abdominal wall, and 6 months after surgery, the difference between the thickness of the anterior abdominal wall in the main group and the comparison group is 3 times.
腹直肌转移患者手术治疗的优化
总结。介绍。本文报告88例腹直肌转移及腹直肌转移合并前腹壁疝的治疗体会。各种类型的腹腔镜和传统手术干预的有效性已被研究。的目标。通过开发和实施新的各种腹腔镜干预措施来优化腹直肌转移患者的手术治疗。材料和方法。88例患者均分为两组。主组43例(女26例,男17例),对照组45例(男19例,女26例)。对照组采用传统方法进行手术干预:根据Sapezhko - 2进行自体成形术;根据Napalkov - 10自动成形术;异体成形术按“嵌体”型- 23;异体外阴成形术按“亚球囊”型- 10。在主要组中,患者在容积中采用纯腹腔镜方法进行手术干预:根据“全内窥镜”类型进行直肠肌肉造影- 7;按照“Total Ergoclose”- 20型固定假体的“Irom”手术;手术“Irom”+再肌造影,假体按“Total Ergoclose”型固定- 13;“E-TEP”手术按照river-Stoppa法进行,假体按照“Total Ergoclose”型固定- 1。研究结果及其讨论。手术的有效性是根据肌肉复制的质量和形成率来评估的,或者转移部位的网状纤维复合体,通过使用超声在三个水平测量前腹壁的厚度:在上腹部-大约7厘米。在肚脐上方,或沿上缘网状移植物固定;脐以上2cm处,或沿补片条件中心;在肚脐以下2cm处,或沿网片下缘固定移植物。每个区域分别于术后第5天、术后1个月、术后6个月进行3次研究。结论。网状纤维复合体的形成,或肌肉复制,在开放式手术中持续的时间比腹腔镜手术要长得多。主组1个月后超声数据显示腹壁自然解剖基本恢复,术后6个月,主组前腹壁厚度与对照组相差3倍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信