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)

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

References

  1. Adamyan A.A., Velichenko R.EH. Mediko-social'nye aspekty plastiki perednej bryushnoj stenki [Health and social aspects of plastics anterior abdominal wall.] Annaly plasticheskoj, rekonstruktivnoj i ehsteticheskoj hirurgii, 1999; 2: 41-48.
  2. Askerhanov R.P. O patogeneze i lechenii diastazy pryamyh myshc zhivota [On the pathogenesis and treatment of diastasi rectus abdominis.] Sovetskaya Medicina, 1962; 11: 68- 75.
  3. Barkov B.A. Operativnoe lechenie diastazov pryamyh myshc zhivota: Avtoreferat dissertacii doktora medicinskih nauk [Surgical treatment of diastase of direct muscles of a stomach: the dissertation of doctor of medical Sciences.] M., 1958; 15.
  4. Barkov B.A. Klinika, klassifikaciya i operativnoe lechenie diastazov pryamyh myshc zhivota [Clinic, classification and surgical treatment of diastasis rectus abdominis.] Sovetskaya medicin, 1962; 11: 71.
  5. Voskresenskij N.V., Gorelik S.L. Hirurgiya gryzh bryushnoj stenki [Surgery of abdominal wall hernias.] M.: Medicina, 1965; 326.
  6. Gireev G.I., Zagirov U.Z., Shahnazarov A.M. Lechenie gryzh beloj linii zhivota i diastaza pryamyh myshc zhivota. Hirurgiya [Treatment of hernias of the white line of the abdomen and diastasis rectus abdominis. Surgery.] 1997; 7: 58-61.
  7. Zhebrovskij V.V., Toskin K.D. Gryzhi bryushnoj stenki [Hernia of the abdominal wall.] M.: Medicina, 1990.
  8. Zhebrovskij V.V., Mohammed Tom EHl'bashir. Hirurgiya gryzh zhivota i ehventracij [Surgery of abdominal hernia and eventration.] Simferopol': Biznes in- form, 2002; 440.
  9. Pushkin S.YU. Hirurgicheskoe lechenie posleoperacionnyh ventral'nyh gryzh i patogeneticheskoe obo- snovanie plastik kombinirovannym sposobom: Avtoreferat dissertacii na soiskanie uchenoj stepeni kandidata medicinskih nauk [Surgical treatment of postoperative ventral hernia and pathogenetic substantiation of plastic combined method: the dissertation on competition of a scientific degree of candidate of medical Sciences.] Samara, 1958.
  10. Nahas F.X., Augusto S.M., Ghelfond C. Should diastasis recti be corrected? Aesthetic. [Should diastasis recti be corrected? Aesthetic.] Plast. Surg., 1997; 21(4): 285–289.
  11. Spitznagle T.M., Leong F.C., Van Dillen L.R. Prevalence of diastasis recti abdominis in a urogynecological patient population. [Prevalence of diastasis recti abdominis in a urogynecological patient population.] Int Urogynecology; J. Pelvic Floor Dysfunct., 2007; 18(3): 312-318.

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