[Experience in treatment of postoperative ventral hernias]

Treatment results in 193 patients with medium and large postoperative ventral hernias were analyzed. All patients were divided into 2 groups. 66 patients operated according to autoplastic methods formed the control group. 127 patients undergoing abdominal wall grafting with use of cellular polypropylene implant formed the main group. Sublay method was used in 48 patients, onlay--in 38 patients, Rives-Stoppa method--in 41 patients. Frequency of local wound postoperative complications and hernia relapses were taken into account for comparative evaluation of surgical treatment results. Hernia relapses developed in 56 patients from the control group and in 115 patients from the main group. Basing on the authors' data autoplastic methods are accompanied by local wound complications (infiltration, suppuration, seroma, haematoma) in 7.9% of observations, alloplastic methods--in 22.8% (chi2 = 6.36, p<0.05). In the control group hernia relapse developed in 18 patients (32.1%), in the main group--in 6 patients (5.2%) (chi2 = 22.63, p<0.001). Hernia relapse was revealed when using onlay method in 8.6% of observations, Rives-Stoppa--in 5.4%, sublay--in 2.3% of observations (chi2 = 1.53, p>0.05). Authors consider that it is necessary to use diverse alloplasic methods treating median postoperative hernias of medium and big sizes. Preference should be given to sublay method.