Оценка Адекватности Искусственной Вентиляции Легких У Пациентов С Морбидным Ожирением Во Время Лапаротомных Бариатрических Операций

Vynnychenko, О. V.

doi:10.22141/2224-0586.3.98.2019.165484

ЕМ

2021

DOI: 10.22141/2224-0586.3.98.2019.165484

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Оценка Адекватности Искусственной Вентиляции Легких У Пациентов С Морбидным Ожирением Во Время Лапаротомных Бариатрических Операций

О. V. Vynnychenko¹

Abstract: Оригінальні дослідженняСтаття написана в межах проведеного дослідження відділу анестезіології та інтенсивної терапії (тема відділу «Профілактика дихальних ускладнень у пацієнтів з морбідним ожирінням», 2015-2018 рр.) ДУ «Національний інститут хірургії та трансплантології ім. О.О. Шалімова НАМН України». ВступОжиріння, згідно з визначенням Міжнародної федерації хірургії ожиріння (International Federation for the Surgery of Obesity (IFSO)), -хронічне багатофакторне генетично обумовлене довічне небезпечне для жит… Show more

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Cited by 2 publications

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Коморбидная Патология В Герниологии

Boyko¹,

Parkhomenko²,

Nіkonov³

et al. 2021

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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.

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Коморбидная Патология В Герниологии

Boyko¹,

Parkhomenko²,

Nіkonov³

et al. 2021

ЕМ

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Simultaneous abdominoplasty and laparoscopic ventral hernia alloplasty in patients with obesity

Бойко

Parkhomenko

et al. 2020

AML

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Aim. To study the results of simultaneous abdominoplasty and laparoscopic ventral hernia alloplasty in patients with obesity. Material and Methods. Simultaneous adbominoplasty and laparoscopic hernioplasty for ventral hernias were performed in 31 patients. The mean age of the patients was 53.7±6.5 (95% CI 51.3; 56.0). All patients were diagnosed as obese (body mass index more than 30 kg/m2). Incisional hernia was the main indication for surgery in the majority of patients - 20 (64,5%); in 11 (35%) cases a primary hernia of median localization was detected. Immediate and long-term results of surgical interventions were studied. Results and Discussion. In the postoperative period after drainage removal accumulations of fluid (seromas) were revealed in 9 (29%) patients using ultrasound investigation; in 2 cases they were evacuated by puncture. In one case, a marginal necrosis of the skin around the formed umbilicus occurred (healing by secondary tension); in another, lower lobe pneumonia was diagnosed (eliminated by antibiotic therapy). The average length of hospital stay was 7.3±1.4 (95% CI 6.8; 7.9) days, 6-8 days in most cases. Only two patients were hospitalized for more than 8 days due to postoperative complications. No recurrences of hernias were registered at follow-up examination 1-3 years later; good cosmetic results were achieved. Conclusions. In patients with ventral hernias with obesity and fat apron it is advisable to perform simultaneous intervention - abdominoplasty and allogernioplasty. It is advisable to perform alloplasty of ventral hernias with simultaneous abdominoplasty via laparoscopic access according to IPOM technology with the use of mesh endoprosthesis with antiadhesive coating. Simultaneous abdominoplasty causes an increase in the frequency of seromas in the postoperative period, but it does not increase the duration of hospital treatment. Simultaneous surgeries allow achieving good cosmetic results and do not increase the incidence of hernia recurrence. Keywords: obesity, fat apron, ventral hernia, abdominoplasty, laparoscopic alogernioplasty, result

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Оценка Адекватности Искусственной Вентиляции Легких У Пациентов С Морбидным Ожирением Во Время Лапаротомных Бариатрических Операций

Cited by 2 publications

References 7 publications

Коморбидная Патология В Герниологии

Коморбидная Патология В Герниологии

Simultaneous abdominoplasty and laparoscopic ventral hernia alloplasty in patients with obesity

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