O uso do pneumoperitônio progressivo no pré-operatório das hérnias volumosas da parede abdominal

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Data

2009-04-01

Autores

Minossi, José Guilherme [UNESP]
Oliveira, Walmar Kerche de [UNESP]
Llanos, Juan Carlos [UNESP]
Ielo, Samuel Moraes [UNESP]
Hasimoto, Claudia Nishida [UNESP]
Pereira, Rodrigo Severo de Camargo [UNESP]

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Resumo

Context - Correction of voluminous hernias and large abdominal wall defects is a big challenge in surgical practice due to technical difficulties and the high incidence of respiratory and cardiovascular complications. Objectives - To present the authors experience with inducing progressive pneumoperitoneum preoperative to surgical treatment of voluminous hernias of the abdominal wall. Methods - Retrospective study of six patients who presented voluminous hernias of the abdominal wall and were operated after installation of a pneumoperitoneum. The procedure was performed by placing a catheter in the abdominal cavity at the level of the left hypochondrium with ambient air insufflation for 10 to 15 days. Results - Four of the six patients were female and two male. Ages ranged from 42 to 62 years. Hernia duration varied from 5 to 40 years. Four patients had incisional, one umbilical, and one inguinal hernias. Mean pneumoperitoneum time was 11.6 days. There were no complications related to pneumoperitoneum installation and maintenance. All hernias were corrected without technical difficulties. The Lichtenstein technique was used to correct the inguinal hernia, peritoneal aponeurotic transposition for one of the incisional hernias, with the rest corrected using polypropylene mesh. One death and one wall infection were observed post operatively. No recurrences were reported until now, in 4 to 36 months of follow-up. Conclusion - Preoperative progressive pneumoperitoneum is a safe and easy executed procedure, which simplifies surgery and reduces post-operative respiratory and cardiovascular complications. It is indicated for patients with hernias that have lost the right of domain in the abdominal cavity.

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Palavras-chave

Hernia, inguinal, Hernia, ventral, Pneumoperitoneum, artificial, abdominal wall hernia, adult, aeration, ambient air, cardiovascular disease, clinical article, death, disease duration, female, follow up, hernioplasty, human, incisional hernia, inguinal hernia, male, pneumoperitoneum, postoperative complication, postoperative infection, preoperative treatment, retrospective study, risk reduction, surgical technique, umbilical hernia, Adult, Female, Follow-Up Studies, Hernia, Abdominal, Hernia, Ventral, Humans, Male, Middle Aged, Pneumoperitoneum, Artificial, Preoperative Care, Retrospective Studies, Severity of Illness Index, Treatment Outcome

Como citar

Arquivos de Gastroenterologia, v. 46, n. 2, p. 121-126, 2009.