Complex surgical treatment of recurrent abdominal wall hernias with abdominal wall fistula | Ukrainian Medical Journal

The aim: to evaluate the effectiveness of surgical treatment of recurrent abdominal wall hernia with abdominal wall fistula after mesh hernia repair.

Object and methods of the research. We analyzed results of treatment of 66 patients with recurrent abdominal wall hernia with abdominal wall fistula, who were divided into 2 groups. In 1st group (n=34) рatients were treated according to the developed algorithm, in 2nd group (n=32) — to the traditional one. We compared the frequency of postoperative complications (seroma, wound infection) and wound healing period.

Results. Seroma occurred in 2 (5.9%) patients of 1st group and in 8 (25.0%) patients of 2nd group (p=0,030), wound infection was observed in 1 (2.9%) patient vs 6 (18.7%) (p=0.037), the wound healing period was 6 (5–7) vs 14 (12–15) days (p=0.0001). No evidence of fistula or hernia recurrence was observed in 1st group, but in 2nd group abdominal wall fistula occurred in 3 (9.4%) patients and recurrent hernia in 2 (6.2%).

Conclusion. The treatment algorithm of recurrent abdominal hernia with abdominal wall fistula, which includes fistula excision with mesh explantation, hernia repair with mesh fixation with polyurethane glue, increases the effectiveness of treatment by decreasing the frequency of seroma, wound infection and the duration of wound healing.

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