Seguridad y efectividad de técnica de separación de componentes y Rives Stoppa en hernia ventral compleja
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Date
2024-08-14
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Universidad Nacional de Trujillo
Abstract
Las hernias ventrales, defectos de la pared abdominal, afectan aproximadamente al 5% de la población mundial. Su incidencia ha aumentado con el envejecimiento, la obesidad y el aumento de cirugías abdominales y su reparación quirúrgica es esencial para prevenir complicaciones como dolor severo, encarcelamiento y obstrucción intestinal.
Las hernias grandes y complejas, definidas por su tamaño o proximidad a huesos prominentes, presentan desafíos significativos con tasas de recurrencia de hasta el 40%. Las técnicas quirúrgicas usadas para repararlas incluyen la técnica de Rives-Stoppa, que emplea una malla que se extiende al espacio preperitoneal, y la técnica de separación de componentes, que crea un espacio retromuscular para un cierre sin tensión. Ambas tienen ventajas y limitaciones en función del tamaño y complejidad de la hernia.
Este estudio evalúa la efectividad y seguridad de las técnicas quirúrgicas para hernias ventrales complejas en pacientes atendidos en el Hospital Belen de Trujillo mediante el uso de pruebas estadísticas, como la Chi Cuadrado y el análisis multivariado, para comparar los resultados de las técnicas Rives-Stoppa y separación de componentes.
Finalmente, se espera mejorar la práctica quirúrgica en el tratamiento de hernias ventrales complejas al optimizar los resultados quirúrgicos y reducir las complicaciones y recidivas, además de promover una gestión integral y efectiva de los pacientes con hernias ventrales complejas.
Palabras clave: Hernia ventral, Hernia abdominal, Pared abdominal, Procedimientos Quirúrgicos Electivos.
Abstract Ventral hernias, which are defects in the abdominal wall, affect approximately 5% of the global population. Their incidence has increased along with the rise of population aging, obesity, and abdominal surgeries, and surgical repair is essential to prevent complications such as severe pain, incarceration, and intestinal obstruction. Large and complex hernias, which are defined by their size or proximity to prominent bones, present significant challenges including recurrence rates of up to 40%. The surgical techniques used to repaire them include the Rives-Stoppa technique, which employs a mesh extending into the preperitoneal space, and the component separation technique, which creates a retromuscular space for a tension-free closure. Both have advantages and limitations depending on the size and complexity of the hernia. This study evaluates the effectiveness and safety of surgical techniques for complex ventral hernias in patients treated at Hospital Belen de Trujillo using statistical tests, such as Chi-Square and multivariate analysis, to compare the outcomes of the Rives-Stoppa technique and component separation technique. Lastly, our goal is to improve surgical practice in the treatment of complex ventral hernias by optimizing surgical outcomes, reducing complications and recurrences, and to promote comprehensive and effective management of patients with complex ventral hernias. Keywords: Hernia, ventral; Hernia, abdominal; Abdominal wall; Elective Surgical Procedures.
Abstract Ventral hernias, which are defects in the abdominal wall, affect approximately 5% of the global population. Their incidence has increased along with the rise of population aging, obesity, and abdominal surgeries, and surgical repair is essential to prevent complications such as severe pain, incarceration, and intestinal obstruction. Large and complex hernias, which are defined by their size or proximity to prominent bones, present significant challenges including recurrence rates of up to 40%. The surgical techniques used to repaire them include the Rives-Stoppa technique, which employs a mesh extending into the preperitoneal space, and the component separation technique, which creates a retromuscular space for a tension-free closure. Both have advantages and limitations depending on the size and complexity of the hernia. This study evaluates the effectiveness and safety of surgical techniques for complex ventral hernias in patients treated at Hospital Belen de Trujillo using statistical tests, such as Chi-Square and multivariate analysis, to compare the outcomes of the Rives-Stoppa technique and component separation technique. Lastly, our goal is to improve surgical practice in the treatment of complex ventral hernias by optimizing surgical outcomes, reducing complications and recurrences, and to promote comprehensive and effective management of patients with complex ventral hernias. Keywords: Hernia, ventral; Hernia, abdominal; Abdominal wall; Elective Surgical Procedures.
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Keywords
Hernia Ventral, Hernia Abdominal, Pared Abdominal, Procedimientos Quirúrgicos Electivos