Профилактика осложнений в хирургии послеоперационных грыж передней брюшной стенки: современное состояние проблемы (обзор)

В обзоре обсуждаются важнейшие аспекты проблемы осложнений в хирургии послеоперационных грыж передней брюшной стенки. Обозначены наиболее актуальные вопросы современной герниологии, ее социально-экономические аспекты. Рассмотрены методы профилактики осложнений в предоперационном, интраоперационном и послеоперационном периодах. При описании методов предоперационного прогнозирования и профилактики осложнений проанализированы современные классификации и интегральные шкалы показателей состояния пациентов, указаны достоинства и недостатки современных методов предоперационной подготовки.

В разделе, посвященном интраоперационному периоду, представлены основные современные способы герниопластики с использованием сетчатых имплантатов, их особенности. Большое внимание уделено описанию вариантов операций в зависимости от размещения сетки по отношению к грыжевым воротам и анатомическим слоям брюшной стенки и оценке типов сетчатых имплантатов, их выбору для конкретной клинической ситуации. Рассмотрены принципы одного из перспективных направлений абдоминальной хирургии — сепарационные методы герниопластики. При анализе методов послеоперационной профилактики грыж акцент сделан на описание принципов технологии fast-track, широко применяемой в различных областях хирургии и набирающей популярность в герниологии.

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