Abstract

ANTUNEZ PENA, Sergio Antonio et al. Clinical and surgical aspects of the complex incisional hernias. Rev Cubana Cir [online]. 2013, vol.52, n.4, pp.230-244. ISSN 0034-7493.

Diagnosis and treatment of complex incisional hermias is a compulsory topic for all surgeons. The challenge ahead is to prevent complications and to reduce relapses, which warrants the conduction of a study with the objective of identifying their most relevant clinical and surgical aspects. Methods: Observational and descriptive study of a case series involving 320 patients operated on from complex incisional hernias at the surgery service of "Dr Juan B. Zayas" university hospital in Santiago de Cuba during 15 years (1994-2009). Results: Females and 31-60 years age group predominated. The suprapubic hernias were the most frequent in both sexes; in females who underwent previous gynecological interventions and in men who underwent prosthatic procedures. Preoperative progressive pneumoperitoneum and prophylactic antibiotic therapy were applied to all patients. The most used surgical techniques were Jean Rives' and Robert Bendavid's and the polypropylene bioprothesis. The relapse index was 6.5% and males predominated. The surgical time ranged 1 to 2 hours and the stay at hospital lasted one to 3 days. Four patients died, which accounted for 1.3% of the case series. Conclusions: The only effective treatment for complex incisional hernias lies in non-tensile surgical technique with correct application of the indicated bioprothesis and its fixing with a suture of the same material, so protocoling and classification of these hernias are recommended in order to unify criteria with respect to their diagnosis and treatment.

Keywords : complex incisional hernia; eventration; ventrocele; laparocele; hernioplasty; herniorraphy; bioprothesis; non-tensile technique.

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