Treatment of patients with complicated course of post-traumatic retroperitoneal cysts is a difficult task due to the relative rarity of this disease. The absence of a single treatment and diagnostic algorithm for this group of patients contributes to the high mortality rate. This clinical case demonstrates the complexities of diagnosis and surgical treatment of patients with multilocular post-traumatic retroperitoneal cyst complicated by recurrent bleeding into the cavity of the cyst and violation of the blood supply to the right side of the colon. Keywords: post-traumatic retroperitoneal cyst; complication; bleeding into the cavity of the cyst; colonic necrosis For citation Sigua B.V., Zemlyanoy V.P., Kozobin A.A., et al. Surgical tactics in patients with multilocular post-traumatic retroperitoneal cyst.

BACKGROUND: To date, the problem of relapse-free treatment in herniology has not been solved. In recent years, the development and wider application of modern technologies in herniology, including endovideosurgical, has been noted. The principles of preparation for surgical interventions, postoperative management and the choice of surgical treatment have also changed significantly, which has affected the improvement of the quality of surgical care for patients with ventral hernias. AIM: To determine the clinical effectiveness of various methods of surgical treatment of patients with ventral hernias by conducting a systematic review and identifying differences associated with statistical heterogeneity in the study findings. MATERIALS AND METHODS: More than 1400 domestic publications devoted to surgical treatment of ventral hernias have been preliminarily studied. Taking into account the inclusion and exclusion criteria, the review included 35 domestic scientific publications dated from 2007 to 2020. 8906 cases of surgical treatment of patients with ventral hernias have been analyzed to assess the results of treatment and the clinical effectiveness of various methods. RESULTS: The wider introduction of endovideosurgical operations into practice has demonstrated the best result in assessing the risk of relapses and postoperative complications. However, the total share of endovideosurgical operations remains small compared to other types of surgical treatment. CONCLUSIONS: Standardized approaches to the management of surgical patients and the prevention of possible complications due to the principles of evidence-based medicine can improve the overall effectiveness of the treatment of patients with ventral hernias.

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The problem of treatment for strangulated incisional hernia does not lose its relevance due to the large number of postoperative complications and high mortality rates, which significantly exceed these indicators in selective surgery. One of the solutions to this problem is to identify patients with a high risk of strangulation, which will allow you to perform the operation in a timely manner and avoid possible complications. The most relevant issue is the timing of surgery in patients with postoperative hernias after strangulation.

BACKGROUND: Currently, there is no consensus and approved tactics for choosing the method of hernioplasty in the surgical treatment of patients of fertile age planning pregnancy with hernias of the anterior abdominal wall. The study is devoted to the comparative analysis of surgical treatment of these patients. AIM: To determine the algorithm of surgical treatment of hernias of the anterior abdominal wall in the patients of fertile age planning pregnancy. MATERIALS AND METHODS: The analysis of the treatment results of fertile age patients with hernias of the anterior abdominal wall in the period from 2010 to 2019 has been carried out. The inclusion criteria were as follows: patients of fertile age who underwent surgical treatment of hernias of the anterior abdominal wall, who did not have a relapse before pregnancy. Thus, 252 patients have been included in the study. RESULTS: The surgical tactics and optimal timing of the operation in patients of fertile age with hernias of the anterior abdominal wall have been determined. CONCLUSIONS: When planning surgical treatment of hernias of the anterior abdominal wall in patients of fertile age, it is necessary to clarify information about pregnancy planning. The most favorable period for planning pregnancy and childbirth is 3 years or more after hernioplasty. When planning a pregnancy in the next 12 years after surgical treatment of a ventral hernia, it is necessary to give preference to hernioplasty with local tissues, which has fewer complications in the long-term postoperative period as well as fewer relapses after childbirth compared with open prosthetic surgery. When planning a pregnancy 3 or more years after surgical treatment, preference should be given to prosthetic hernioplasty. When analyzing the results of treatment of the patients of fertile age with inguinal and femoral hernias, planning pregnancy, clinical experience has shown that there are no contraindications to performing laparoscopic transabdominal preperitoneal prosthetic hernioplasty.