Dynamics of concentration of C-reactive protein after hernioplasty and simultaneous interventions

Abstract

Were analyzed 127 case histories of patients aged (54.3±13.6) years; 44 women (34.6%) who underwent hernia plastic surgery of different localization: 26 (20.5 %) umbilical and paraumbilical; 25 (19.7%) - incisional, 68 (53.6%)-inguinal and 8 (6.3%)-hiatalhernia. 64 (50.4%) patients underwent simultaneous operations: for multiple hernias - 35 (27.6%), cholecystolithiasis I, chronic cholecystitis - 14 (11.0%), gynecological pathology - 6 (4.7%), chronic appendicitis - 3 (1.4%), or abdominoplasty due to fatty deformity of the anterior abdomen walls (fat «apron») - 6 (4.7%). The initial condition of the patient features of surgery and the dynamics of the concentration of C-reactive protein (CRP), which was determined before surgery, in the first, third and fifth days after. It was found that the initial concentration of CRP is increased in some cases in patients with overweight and obesity, as well as in the presence of chronic cholecystitis or chronic appendicitis. In the postoperative period, regardless of the location of the hernia and the method of surgery, there is an increase in the concentration of CRP, which is most pronounced in the first day after surgery and indicates the activation of systemic inflammatory responses. The increase in CRP concentration on the first day was greatest after hiatal hernia repair and after simultaneous operations, especially after abdominoplasty. In overweight and obese patients, an increase in CRP is observed up to the fifth day after surgery, indicating a prolonged activation of the inflammatory response. The concentration of CRP on the first and third days after isolated operations did not depend on the method of operation («open» alloplastic, open autoplastic or laproscopic hemioplasty), but was the lowest on the fifth day after laparoscopic hemioplasty. Keywords: hemioplasty, simultaneous operations, C-reactive protein, dynamics.