Eventration in emergency abdominal surgery - a new approach to an old problem

Objective: to improve the results of treatment of patients by eliminating the eventration of abdominal wall plastic with a polypropylene prosthesis, taking into account the level of intra-abdominal pressure. Materials and methods. The results of treatment of 36 emergency abdominal surgical patients who developed an eventration on the background of purulent peritonitis and acute intestinal obstruction were studied. In group 1 (n = 18), the treatment consisted in suturing the abdominal wall through all layers, and in group 2 (n = 18), endoprosthesis of the abdominal wall was performed using the inlau technique under the control of intra-abdominal pressure. The results of treatment were evaluated by the number of complications, mortality and quality of life of patients in the long-term period. Results. In the immediate postoperative period, 63.1% of patients in group 1 developed complications with a mortality rate of 55.6%, and in group 2, respectively, 36.9% with a mortality rate of 44.4%. When studying the quality of life of surviving patients in group 2, an increase in the physical component of health was noted - by 20.4%, the psychological component - by 20.7%. In the first group, the results of treatment were not satisfactory due to the development of severe peritoneal adhesions and large postoperative hernias. In patients of group 2, clinical manifestations of adhesive peritoneal disease were mild or moderate, there were no postoperative hernias. Conclusion: elimination of eventration by endoprosthetics of the abdominal wall under the control of intra-abdominal pressure allows to improve the results of treatment of patients.