Evaluation of Intraabdominal Presure changes after large Abdominal hernia Surgeries

• Authors: Fryderyk Pukacki , Maciej Zieliński , Michał Grzeszczak
• Languages of publication: EN

Abstracts

EN

Occurrence of systemic complications after a large abdominal hernia operation depends on the increase of intraabdominal pressure (IAP). It is thus essential to device a preoperative method to predict IAP level changes in perioperative period.The aim of the study was evaluation of our own mathematical calculation of hernial sac volume in prognosis of intraabdominal pressure changes after abdominal wall reconstruction.Material and methods. Between January 2006 and November 2007 32 patients were operated because of a large abdominal hernia. Secondary hernias made up 68.8%, whereas primary hernias 31.3%. Mean patients' age was 67.5 years. Using our own method of mathematical calculation of hernial sac volume, the patients were divided into groups according to hernia size. Intraabdominal pressure values and their influence on respiratory, circulatory and excretory systems have been analyzed. The operation was conducted under intratracheal anesthesia. The abdominal wall plasty was carried out using a polypropylene mesh that has been placed in the prefascial retromuscular space.Results. No perioperative deaths were observed. The highest mean IAP increase occurred after hernial ring closure, whereas the highest mean abdominal perfusion pressure (APP) drop was observed in the first 24 hours after the operation. There was observed a positive correlation between hernial sac volume (HSV) and IAP values and a negative one between HSV and APP value. There was observed a decrease of diuresis, saturation, blood pressure and an increase of urea and creatinine in the first 24 hours after the operation.Conclusions. A non-invasive hernial sac volume measurement helps to predict postoperative IAP growth and thus development of general complications. Pressure-free operations seem to be safe in terms of preventing post-operative intraabdominal pressure growth.

Keywords

EN

abdominal hernia; intraabdominal pressure; abdominal compartment syndrome; hernial sac volume calculation

• Publisher: Index Copernicus International
• Journal: Polish Journal of Surgery
• Year: 2010
• Volume: 82
• Issue: 5
• Pages: 259-266

Dates

published

1 - 5 - 2010

online

15 - 9 - 2010

Contributors

author

Fryderyk Pukacki

• Chair and Department of General and Vascular Surgery, Medical University in Poznań

author

Maciej Zieliński

• Chair and Department of General and Vascular Surgery, Medical University in Poznań

author

Michał Grzeszczak

• Department of Surgery, Independent Public Hospital in Oborniki

References

• Burger JW, Lange JF, Halm JA: Incisional hernia: early complication of abdominal surgery. World J Surg 2005; 29: 1608-13.[Crossref][PubMed]
• Cassar K, Munro A: Operacyjne leczenie przepu-kliny w bliźnie pooperacyjnej. Br J Surg 2002; 89: 534-45.
• Vegar-Brozovic V, Brezak J, Brozovic I: Inta-abdominal hypertention: pulmonary and cerebral complications. Transplant Proc 2008; 40: 1190-92.[Crossref][WoS]
• Doty J, Oda J, Ivatury R et al.: The effects of hemodynamic shock and increased intraabdominal pressure on bacteria translocation. J Trauma 2002; 52: 13-17.[Crossref]
• Deenichin GP: Abdominal compartment syndrome. Surg Today 2008; 38: 5-19.[WoS][PubMed][Crossref]
• Empacher AB, Sęp Z, Żakowska A, Żakowski W: Mały Słownik Matematyczny str. 44, Wiedza Powszechna, Warszawa 1975.
• Bieda K, Sobczyński P, Szulc R: Nadciśnienie śródbrzuszne - czy tylko problem chirurgiczny? Anestezjologia Intensywna Terapia 2003; 35: 44-47.
• Lemańczyk A: Statystyka w pigułce. Wydawnictwo Naukowe UM im. K. Marcinkowskiego w Poznaniu 2008.
• Bronsztejn I, Siemiendiajew K, Musiol G: Nowoczesne Kompendium Matematyki. PWN, Warszawa 2004; 12: 168-71.
• Requeira T, Bruhn A, Hashun P et al: Intraabdominal hypertension: incidence and association with organ dysfunction during early septic shock. J Crit Care 2008; 23: 461-67.[Crossref][WoS]
• Maerz L, Kaplan LJ: Abdominal compartment syndrome. Crit Care Med 2008; 36 (supl. 4): s. 212-15.[Crossref]
• Sugrue M: Intraabdominal pressure: time for clinical practice guidelines? Int Care Med 2002; 28: 389-91.[Crossref]
• Graca L, Araujo L, Rudy M et al.: Intra-abdominal pressure in abdominoplasty patients. Aesth Plast Surg 2006; 30: 655-58.
• Talizman R, Kaplan B, Haik J et al.: Measuring alterations in intra-abdominal pressure during abdominoplasty as a predictive value for possible postoperative complications. Aesth Plast Surg 2002; 26: 189-92.
• Bieda K: Wartość prognostyczna pomiaru ciśnienia śródbrzusznego w ostrych chorobach jamy brzusznej. Rozprawa doktorska, UM Poznań 2005.
• Grzeszczak M: Operacja przepukliny brzusznej i jej wpływ na wartość ciśnienia śródbrzusznego, Rozprawa doktorska, UM Poznań 2009.
• Bułhak-Guz H, Burcan J, Józefowicz L: Leczenie operacyjne pacjentów z wrodzonymi wadami powłok z monitorowaniem ciśnienia śródbrzuszne go prototypowym miernikiem ciśnienia śródpęche-rzowego. Mechanika w medycynie 2002; 6: 13-19.
• Cheatham ML, White M, Sagraves S et al.: Abdominal perfusion pressure: a superior parametr in the assessment of intra-abdominal hypertension. J Trauma 2000; 49: 621-27.[Crossref]
• Kirkpatrick AW, Balogh Z, Ball CG et al.: The Secendary abdominal syndrome: iatrogenic or unavoidable? Am Coll Surg 2006; 202: 668-79.
• Trivellini G, Bagni C, Sollini A et al.: Repair of giant hernias using more prothesis. Hernia 2001; 5: 124-28.
• Arenal J, Rodriguez-Vielba P, Gallo E et al.: Hernias of the abdominal wall in patients over the age of 70 years. Eur J Surg 2002; 168: 460-63.[Crossref]
• Balogh Z, Moore FA, Moore EE et al.: Secendary abdominal compartment syndrome: a potential threat for trauma clinicians. Injury 2007; 38: 272-79.[WoS][Crossref]
• Madigan MC, Kemp CD, Johnson JC: Secondary abdominal compartment syndrome after severe extremity injury: are early, aggressive fluid resuscitation strategies to blame? J Trauma 2008; 64: 280-85.[PubMed][Crossref][WoS]
• Pukacki F, Oszkinis G, Balcerkiewicz K: Zespół wzmożonej ciasnoty wewnątrzbrzusznej. Pol Przegl Chir 2002; 74: 440-46.

Identifiers

DOI

10.2478/v10035-010-0036-7