Distant Results of Surgical Treatment in Patients with Umbilical Hernia and Diastasis Recti

Юрасов A.В.; Абовян Л.A.; Курашвили Д.Н.; Лысенко M.В.; Дубров В.E.

doi:10.18499/2070-478X-2014-7-4-309-314

Distant Results of Surgical Treatment in Patients with Umbilical Hernia and Diastasis Recti

Authors: ¹, ², ³, ³, ²
Affiliations:
1. Non-state operated medical institution “Central clinical hospital Nr. 1 of the JSC “Russian Railways”, 84 Volokolamskoe Rte, Moscow,125367, Russian Federation1 Lomonosov Moscow State University, Faculty of Basic Medicine, 31/5 Lomonosovskii Ave, Moscow, 119192, Russian Federation
2. Lomonosov Moscow State University, Faculty of Basic Medicine, 31/5 Lomonosovskii Ave, Moscow, 119192, Russian Federation
3. Non-state operated medical institution “Central clinical hospital Nr. 1 of the JSC “Russian Railways”, 84 Volokolamskoe Rte, Moscow,125367, Russian Federation
Issue: Vol 7, No 4 (2014)
Pages: 309-314
Section: Original articles
URL: https://vestnik-surgery.com/journal/article/view/222
DOI: https://doi.org/10.18499/2070-478X-2014-7-4-309-314
ID: 222

Cite item

Abstract

Relevance The approaches to surgical treatment of patients with a combination of umbilical hernia and diastasis recti, remain controversial and need further investigation. The purpose of the study To improve the results in surgical treatment of patients with a combination of umbilical hernia and diastasis recti. Materials and methods We assessed the recurrence rate and development during a three year period after surgical treatment of 262 patients with combined umbilical hernia and diastasis recti. The patients were divided into 9 groups according to the size of the diastasis recti and the applied surgical procedure: a novel method of extraperitoneal prosthetic correction of the diastasis recti and umbilical hernia, autogenous umbilical hernioplasty without correction of the diastasis and simultaneous autogenous hernioplasty and correction of the diastasis using Championniere’s or Askerkhanov’s methods. Results and their discussion There were no cases of recurrence reported, when the novel method was used. After autogenous umbilical hernioplasty without correction of the diastasis relapses occurred in 9 (15,25%) and 29 (70,73%) patients with grade 1 and 2 diastasis, respectively. After simultaneous autogenous hernioplasty and correction of the diastasis a relapse occurred in 12 (30,77%) patients with a grade 2 diastasis and in 15 (93,75%) patient with a grade 3 diastasis. All cases of relapse occurred within the first year after the surgical treatment. Conclusion 1) In the presence of rectus diastasis isolated umbilical hernioplasty leads to a high recurrence rate (15,25% in patients with grade I diastasis and 70,73% in grade II), no matter how large the diastasis was. 2) Surgical procedures combining umbilical hernioplasty and autogenous correction of the diastasis are more effective (recurrence rate 30,77%) than isolated umbilical hernioplasty (recurrence rate 70,73%), but are considerably inferior to the method of extraperitoneal prosthetic correction of the diastasis recti and umbilical hernia (no recurrences at all). The effectiveness of autoplastic procedures considerably decreases with an increasing degree of diastasis (recurrence rate 30,77% in grade II diastasis, 93,75% in grade III diastasis). 3) Extraperitoneal prosthetic correction of the diastasis recti and umbilical hernia is considerably superior to both the isolated autogenous umbilical hernioplasty (recurrence rate 15,25% in patients with grade I diastasis and 70,73% in case of grade II diastasis) and the combined autogenous diastasis correcting methods (recurrence rate 30,77% in patients with grade II diastasis, 93,75% in case of grade III)

Keywords

Пупочная грыжа, диастаз прямых мышц живота, протезирующая внеперитонеальная пластика диастаза прямых мышц и пупочной грыжи, ликвидация диастаза по Championniere, ликвидация диастаза по Аскерханову, рецидив

About the authors

Non-state operated medical institution “Central clinical hospital Nr. 1 of the JSC “Russian Railways”, 84
Volokolamskoe Rte, Moscow,125367, Russian Federation1
Lomonosov Moscow State University, Faculty of Basic Medicine, 31/5 Lomonosovskii Ave, Moscow, 119192,
Russian Federation

Author for correspondence.
Email: author@vestnik-surgery.com
- MD, Prof., Surgeon of Non-state operated Medical Institution “Central Clinical Hospital Nr. 1of the JSC Russian Railways”; Prof. of the Chair of General and Special Surgery of Lomonosov Moscow State University, Faculty of Basic Medicine; Russian Federation

Lomonosov Moscow State University, Faculty of Basic Medicine, 31/5 Lomonosovskii Ave, Moscow, 119192,
Russian Federation

Email: levan@abovyan.biz
Post-graduate student at the Chair of General and Special Surgery; Russian Federation

Non-state operated medical institution “Central clinical hospital Nr. 1 of the JSC “Russian Railways”, 84
Volokolamskoe Rte, Moscow,125367, Russian Federation

Email: author@vestnik-surgery.com
Ph.D., Surgeon of Non-state operated Medical Institution “Central Clinical Hospital Nr. 1of the JSC Russian Railways Russian Federation

Non-state operated medical institution “Central clinical hospital Nr. 1 of the JSC “Russian Railways”, 84
Volokolamskoe Rte, Moscow,125367, Russian Federation

Email: author@vestnik-surgery.com
- MD, Prof., Head of surgical Department of Non-state operated Medical Institution “Central Clinical Hospital Nr. 1of the JSC Russian Railways” Russian Federation

Lomonosov Moscow State University, Faculty of Basic Medicine, 31/5 Lomonosovskii Ave, Moscow, 119192,
Russian Federation

Email: author@vestnik-surgery.com
MD, Prof., Head of the Chair of General and Special Surgery of Lomonosov Moscow State University, Faculty of Basic Medicine Russian Federation

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