Abstract:
Introduction. The inguinal hernia in cirrhotic patients with ascitesperitonitis is a secondary and frequent recurrent pathology due to
intradominal increased pressure.Purpose. The objective of this study is to provide inguinal hernia repair
with mesh and platelet rich fibrin in decompensated cirrhosis. Materials and methods. Was performed an study on 28 patients with
inguinal hernia combined with liver cirrhosis and massive ascitesperitonitis.
I group – 18 patients with ascites and spontaneous bacterial peritonitis
was performed laparoscopic abdominal cavity lavage with antibacterial
and drainage combined with hernia. It was done to them all repairs of
inguinal hernia method “tension- free no mesh”.
II group : 10 cirrhotic patients and ascites-peritonitis was performed mesh
hernioplasty with platelet rich fibrin and laparoscopic drainage. Results. Mortality - 2 (8.69%) patients, due of hepatic failure after 2
months of hospitalization, in I group. Recidivism of hernia at 1 year
observed in 1 (4,34%) patient in I group, but in second group recidivism
were not observed. Was none postoperative wound suppuration.Conclusions.
1. Inguinal hernioplasty “tension free no mesh” must be performed in
cirrhotic patients with spontaneous bacterial ascites-peritonitis.
2. Hernioplasty with laparoscopic abdominal drainage and lavage with
antibacterial reduces the risk of ascites-peritonitis and improves
wound healing.
3. At patients without spontaneous bacterial peritonitis can be
performed mesh hernioplasty with laparoscopic drainage and
lavage.
4. Cirrhotic patients with hernia and ascites preferable operated
planned.
Description:
State University of Medicine and Pharmacy "Nicolae Testemitanu“,
Surgery department N2, “Constantin Tibirna” Surgery Clinic, Scientific Research Laboratory Hepatic Surgery
