The Value of Functional Tests in Patients with Chronic Obstructive Pulmonary Disease and Ventral Hernias in Preoperative Period

Relevance Today the prediction of possible respiratory disorders in patients with COPD and ventral hernias in postoperative period is actual by using available functional tests in order to prevent negative hernioplasty by choosing relatively safe herniotomy variant, programs of preoperative and postoperative management of patients. Materials and methods We examined 66 patients with COPD stage 1–2 with the anterior abdominal wall hernias (20 of them - with umbilical hernias, 18 - with linea alba hernias, 28 - with median post-operative hernias). All patients prior to surgery performed spirometry and capnometry before and 20 min after the reduction of hernia bag contents with bandage fixation. Studies were repeated on the second day after hernia repair. Results and their discussion As a result the functional tests using spirometry and capnometry were uneven. Before an operation during the test the parameters of spirometry did not change, while on the 2nd day after surgery in patients with hernia defect size more than 8 cm change in respiratory function parameters were significant. Capnometry test with evaluation of the functional dead space in the alveolar ventilation (FDSAV) was more consistent in terms of forecasting the possible lung function disorders in COPD patients in early postoperative period. No change of FDSAV or increase in the normal range (35% of tidal volume) may indicate a relatively favorable prognosis. If the value is higher than 35%, significant lung function disorders are possible in early postoperative period. Conclusion In patients with COPD and ventral hernias the prediction of possible violations of respiratory system as the syndrome of abdominal compression in the preoperative stage is important as it allows to choose a relatively safe variant of surgery, the management tactics of patient, which may reduce the frequency of postoperative complications, reduce the length of hospital stay

Ventral hernia, chronic obstructive pulmonary disease, functional tests, capnometry, spirometry