For the Medical Practitioners
doi: 10.25005/2074-0581-2021-23-4-609-617
SURGICAL REPAIR OF LATERAL AND ANTEROLATERAL HERNIAS OF THE ABDOMINAL WALL

M.Kh. Malikov¹,², F.B. Bokiev², I.T. KHO MIDOV¹, O.M. Khudoydodov¹, F.M. Khamidov, N.A. MAKHMADKULOVA³

1Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
2Department of Endoscopic Surgery, Republican Scientific Center for Cardiovascular Surgery, Dushanbe, Republic of Tajikistan
3Department of Topographic Anatomy and Operative Surgery, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: To improve the results of surgical treatment of primary, postoperative and recurrent hernias of the lateral and anterolateral abdominal wall.

Methods: Various types of hernioplasty were performed in 68 patients with lateral and anterolateral hernias of the abdominal wall (LALHAW) aged 24 to 67 years. Primary hernias were diagnosed in 10 patients, postoperative – in 30, recurrent – in 28. There were 16 men and 52 women enrolled on the study. Analysis of the anamnesis and medical records revealed that postoperative hernias (30) arose after the following surgical interventions: nephrectomy (11), nephrolithomy (8), appendectomy (4), cholecystectomy (3), drainage of the retroperitoneal space (2), surgery for hepatic echinococcosis (1) and adrenalectomy (1); 24 patients were admitted with recurrent hernia after traditional hernioplasty, and 4 patients – after combined methods of hernioplasty.

Results: Among the total number of patients, traditional hernioplasty was performed in 25 (36.8%) patients, tension-free repair – in 5 (7.4%) and combined repair – in 38 (55.8%) patients. Simultaneous operations were performed in 14 cases, such as nephrolithotomy (3), resection of the ovarian cyst (3) and greater omentum (5), supravaginal amputation of the uterus (3). Surgical site complications developed in 12% of cases after traditional hernioplasty, and in 5.2%. after combined methods of operation. Among 5 patients operated using a tension-free method, seroma occurred in one observation. Recurrent hernia after traditional hernioplasty developed in one patient (4% of cases).

Conclusion: Surgical treatment of LALHAW is a complicated problem of herniology, due to the complexity of anatomical architectonics of the anterior abdominal wall and limited plastic resources of the surrounding tissues. Currently, the results of traditional hernioplasty remain disappointing, as there is a trend towards increased recurrence and incidence of surgical site complications after its application. The widespread use of the combined methods of surgical treatment of hernias of this localization, along with reliable reinforcement of the hernia defect, provide the most optimal longterm functional results, allowing the patients resume their previous professional activities. The incidence of recurrent hernias after these operations tends to reduce, contributing to an improvement in the quality of life.

Keywords: Lateral abdominal hernia, anterolateral abdominal hernia, recurrent hernia, traditional hernioplasty, tension-free hernioplasty.

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Authors' information:

Malikov Mirzobadal Khalifaevich
Doctor of Medical Sciences, Associate Professor, Head of the Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University
ORCID ID: 0000-0002-7816-5521
E-mail: mmirzobadal@mail.ru

Bokiev Fatkhullo Bakhhshuloevich
Candidate of Medical Sciences, Head of the Department of Endoscopic Surgery, Republican Scientific Center for Cardiovascular Surgery
Researcher ID: ABD-4776-2020
ORCID ID: 0000-0003-2807-2324
SPIN: 5254-1132
E-mail: fathullo-@mail.ru

Khomidov Ilkhomiddin Toirovich
PhD Student, Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University
E-mail: Khomidov.1991@list.ru

Khudoydodov Oyatullo Makhmadulloevich
PhD Student, Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University
E-mail: doctoroyatullo@mail.ru

Khamidov Faridun Marufovich
PhD Student, Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University
Researcher ID: C-3900-2019
ORCID ID: 0000-0002-0759-5636
SPIN: 2266-6447
Author ID: 1094615
E-mail: Faridun_74@mail.ru

Makhmadkulova Nigora Akhtamovna
Candidate of Medical Sciences, Assistant of the Department of Topographic Anatomy and Operative Surgery, Avicenna Tajik State Medical University
ORCID ID: 0000-0002-4269-6611
E-mail: malikovanigora@mail.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from companies manufacturing medications and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Malikov Mirzobadal Khalifaevich
Doctor of Medical Sciences, Associate Professor, Head of the Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University

734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139

Tel.: +992 (907) 305060

E-mail: mmirzobadal@mail.ru

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  3. SURGICAL MANAGEMENT OF POST-BURN SCAR EXTENSION CONTRACTURES OF THE TOES
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