Systematic review of the clinical efficacy of various methods of surgical treatment of patients with ventral hernias

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Abstract

BACKGROUND: To date, the problem of relapse-free treatment in herniology has not been solved. In recent years, the development and wider application of modern technologies in herniology, including endovideosurgical, has been noted. The principles of preparation for surgical interventions, postoperative management and the choice of surgical treatment have also changed significantly, which has affected the improvement of the quality of surgical care for patients with ventral hernias.

AIM: To determine the clinical effectiveness of various methods of surgical treatment of patients with ventral hernias by conducting a systematic review and identifying differences associated with statistical heterogeneity in the study findings.

MATERIALS AND METHODS: More than 1400 domestic publications devoted to surgical treatment of ventral hernias have been preliminarily studied. Taking into account the inclusion and exclusion criteria, the review included 35 domestic scientific publications dated from 2007 to 2020. 8906 cases of surgical treatment of patients with ventral hernias have been analyzed to assess the results of treatment and the clinical effectiveness of various methods.

RESULTS: The wider introduction of endovideosurgical operations into practice has demonstrated the best result in assessing the risk of relapses and postoperative complications. However, the total share of endovideosurgical operations remains small compared to other types of surgical treatment.

CONCLUSIONS: Standardized approaches to the management of surgical patients and the prevention of possible complications due to the principles of evidence-based medicine can improve the overall effectiveness of the treatment of patients with ventral hernias.

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About the authors

Dmitry S. Syomin

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: cosmo@list.ru
ORCID iD: 0000-0002-5630-4914
SPIN-code: 9434-4321
Scopus Author ID: 57194730925

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Badri V. Sigua

North-Western State Medical University named after I.I. Mechnikov

Email: dr.sigua@gmail.com
ORCID iD: 0000-0002-4556-4913
SPIN-code: 5571-8893

Dr. Sci. (Med.), Professor

Russian Federation, Saint Petersburg

Pavel A. Kotkov

North-Western State Medical University named after I.I. Mechnikov

Email: kotkovdr@mail.ru
ORCID iD: 0000-0002-9762-9854
SPIN-code: 3802-2076

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Elena G. Timofeeva

North-Western State Medical University named after I.I. Mechnikov

Email: elenaexcelent@gmail.com
ORCID iD: 0000-0003-4989-5362
Russian Federation, Saint Petersburg

Alexander A. Kozobin

North-Western State Medical University named after I.I. Mechnikov

Email: akozobin@mail.ru
ORCID iD: 0000-0003-1527-3848
SPIN-code: 6240-4321

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Kirill V. Fetisov

North-Western State Medical University named after I.I. Mechnikov

Email: Kirill.Fetisov@szgmu.ru
SPIN-code: 9722-6861

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Vyacheslav P. Zemlyanoy

North-Western State Medical University named after I.I. Mechnikov

Email: yacheslav.zemlyanoy@szgmu.ru
ORCID iD: 0000-0001-7368-5926

MD, Dr. Sci. (Med.), Professor

Russian Federation, Saint Petersburg

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Supplementary files

Supplementary Files
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1. JATS XML
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2. Fig. 1. Comparison of the frequency of specific complications in the subgroups of plastic surgery with local tissues and prosthetic hernioplasty. CI — confidence interval; M-H — Mantel-Haenszel test; df — degrees of freedom

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3. Fig. 2. Comparison of the frequency of specific complications in the subgroups of plastic surgery with local tissues and laparoscopic hernioplasty. CI — confidence interval; M-H — Mantel-Haenszel test; df — degrees of freedom

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4. Fig. 3. Comparison of the frequency of specific complications in the subgroups of prosthetic hernioplasty and laparoscopic hernioplasty. CI — confidence interval; M-H — Mantel-Haenszel test; df — degrees of freedom

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5. Fig. 4. Comparison of the frequency of nonspecific complications in the subgroups of plastic surgery with local tissues and prosthetic hernioplasty. CI — confidence interval; M-H — Mantel-Haenszel test; df — degrees of freedom

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6. Fig. 5. Comparison of the frequency of nonspecific complications in the subgroups of plastic surgery with local tissues and laparoscopic hernioplasty. CI — confidence interval; M-H — Mantel-Haenszel test; df — degrees of freedom

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7. Fig. 6. Comparison of the frequency of nonspecific complications in the subgroups of prosthetic hernioplasty and laparoscopic hernioplasty. CI — confidence interval; M-H — Mantel-Haenszel test; df — degrees of freedom

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8. Fig. 7. Comparison of recurrence rates in the subgroups of plastic surgery with local tissues and laparoscopic hernioplasty. CI — confidence interval; M-H — Mantel-Haenszel test; df — degrees of freedom

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9. Fig. 8. Comparison of the frequency of relapses in the subgroups of plastic surgery with local tissues and laparoscopic herniplasty. CI — confidence interval; M-H — Mantel-Haenszel test; df — degrees of freedom

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10. Fig. 9. Comparison of recurrence rates in the subgroups of prosthetic hernioplasty and laparoscopic hernioplasty. CI — confidence interval; M-H — Mantel-Haenszel test; df — degrees of freedom

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