Коморбидная Патология В Герниологии

Abstract

In recent decades, there has been an aging population worldwide with an increasing proportion of the elderly and senile, leading to a significant increase in the prevalence of a variety of pathologies, especially cardiovascular disease, overweight and obesity, diabetes, neoplastic and dysplastic diseases, and diseases that require surgical treatment. The negative impact on health significantly increases in the presence of several diseases, which creates qualitatively new conditions that cannot be explained by the mechanical sum of the impact of individual diseases. The presence of concomitant pathology in surgical diseases, or comorbidity, adversely affects the general condition of the patient, the course of the underlying and concomitant pathology, and from a surgical point of view also the response to surgical aggression, postoperative period, and further rehabilitation of patients. This indicates the need for an individual approach to the organization of the patient’s examination and planning further treatment, which in most cases cannot be standardized. Age factors, overweight, and obesity, chronic obstructive pulmonary disease, chronic heart failure, coronary heart disease are considered the risk factors and predictors of mortality and complications after surgery. Comprehensive assessment of comorbidity and functional status allows optimizing patient care. The Charlson Comorbidity Index is most often used for this purpose. But the attempts to further increase the informativeness of comorbidity scales do not stop and new ones appear, which are used mainly for the administrative evaluation of treatment results. In the context of herniology, a very interesting pathological condition is connective tissue dysplasia, which is characterized by multiorgan and multisystem lesions with extremely diverse clinical manifestations. Connective tissue pathology is associated with many other surgical diseases. These are varicose veins, biliary dyskinesia with the development of gallstones, duodenogastric and gastroesophageal reflux, peptic ulcer of the stomach and duodenum, diverticula of the digestive tract, adhesive disease of the abdominal cavity. Thus, patients with hernias, especially the elderly and senile, have a fairly high incidence of comorbid pathology, which has a significant impact on the incidence of postoperative complications and mortality.