Mesh endoprosthesis improves quality of life, reduces complications in patients with ventral hernias

Russia: A new study published in the British Journal of Surgery found a low percentage of wound complications, relapses and significant improvement in the patient's quality of life during the five-year period after anterior separation hernioplasty for ventral hernias. 

Ventral hernias, or hernias of the abdominal wall, are a very common type of hernia. Mostly they are formed after surgery. If the postoperative scar healed badly, for example, due to infection, a protrusion of the anterior abdominal wall develops. In the early stages, it is noticeable only when lifting weights and coughing. In the later stages, it is also visible externally; it causes pain, especially with fast walking and sudden movements.

In some cases, a postoperative ventral hernia can reach a huge size. Recently, mesh endoprostheses, or meshes, have been used to treat postoperative ventral hernias. During the operation - hernioplasty - the surgeon sets the abdominal organs in place, and an implant in the form of a mesh is installed in the area of the hernia "gate". Such meshes implant well and do not interfere with the work of organs, which reduces the recovery period. Surgeons of RUDN University, under the guidance of Professor Andrei V. Protasov, MD, head of the Department of Operative surgery and clinical anatomy by I.D. Kirpatovskij followed the recovery of patients after such operations for five years.

“Operations for hernias of the anterior abdominal wall take the second place in the number of surgical operations performed. Only operations for acute appendicitis get ahead of them. Our goal was to conduct a retrospective analysis of data in the five-year period of time and evaluate the results of surgeries,” Serdar Kuliev, surgeon, associate professor of the Department of Operative Surgery and Clinical Anatomy, PhD, RUDN University.

Doctors conducted a comparative study and assessed complications and the quality of the patient’s life with postoperative ventral hernias after hernioplasty. Totally 96 patients participated in the study. The patients were followed up for five years after the hernioplasty using mesh endoprostheses. Complications were estimated using the Clavien-Dindo scale, the standard classification of surgical complications. Surgeons also compared the quality of life using the EuraHS QoL questionnaire developed by the European Society of Herniology.

Wound complications were found in 11.4% of patients, and general complications at 4.2%. Only 1% had a recurrent hernia. Most patients (more than 70%) felt significant improvement: the pain decreased, and physical activity and satisfaction with appearance increased. All that happened in three months after the operation.

“Our results show that there is a low percentage of wound complications and relapses during the five-year period after hernioplasty with the mesh endoprosthesis. The quality of patient’s life is also significantly improved,” Anna Kulakova, surgeon, assistant of the Department of Operative Surgery and Clinical Anatomy, PhD, MD, RUDN University.

Reference:

A L Kulakova, A V Protasov, S Kuliev, I Evsukova, A Borsuk, P-087 ANALYSIS OF COMPLICATIONS AND QUALITY OF LIFE IN PATIENTS AFTER 5 YEARS OF ANTERIOR SEPARATION HERNIOPLASTY, British Journal of Surgery, Volume 109, Issue Supplement_7, October 2022, znac308.185, https://doi.org/10.1093/bjs/znac308.185