OPERATSIYADAN KEYINGI VENTRAL CHURRALARDA GERNIOALLOPLASTIKANI TANLASH MEZONLARINI ASOSLASH
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Ventral churra, gernioalloplastika, standart yondashuv, ekstrakorporal choklar, yaratilgan preperitoneal cho`ntak.##article.abstract##
Butun jahon sog‘liqni saqlash tashkiloti ma’lumotlariga ko‘ra qorin oldingi devori churrasi keng tarqalgan jarrohlik kasalliklardan biri hisoblanib, 3-7% aholi orasida kuzatiladi va asosan mehnatga layoqatli yoshdagi aholi orasida kasallik kuzatiladi. Barcha laparotomiyalarning 5% dan ortig‘i operatsiyadan keyingi ventral churralarning shakllanishi bilan asoratlanadi, bundan tashqari, ularning paydo bo‘lish chastotasi jarrohlik aralashuvining tabiati va shoshilinchligiga bog‘liq bo‘ladi. Barcha jarrohlik aralashuvlarning qariyb 10% ini, ventral churralarni bartaraf etish operativ yondashuvi tashkil qiladi.
Operatsiyadan keying ventral churralarda gernioalloplastika usulini tanlashda, qorin old devorining nuqsoni hajmini va churraning qorin bo`shlig`i hajmiga nisbatini aniqlash, kompyuter tomografiyasi ma`lumotlariga asoslangan bo`lishi kerak.
IPOM metodida laparoskopik gernioalloplastika kichik va o`rta hajmli (W1-W2) operatsiyadan keyingi ventral churralarda endoprotezni mahkamlashning texnik jihatlarini takomillashtirish operatsiyani bajarish texnikasini ancha soddalashtirdi va uning davomiyligini qisqartirdi.
Oldindan o`rnatilgan П-simon choklar yordamida “onlay“ usulda taranglashmagan gernioalloplastikani va kombinatsiyalashgan “onlay+sublay“ usuli bilan endoprotezni implantatsiya qilishning taktik va texnik jihatlarini optimallashtirish, compartment sindromini rivojlanishini va keying katta va gigant (W3-W4) o`lchamdagi churralarda kasallikning qaytalanishini kamayishiga imkon berdi.
Gernioalloplastika usulini tanlash mezonlari asosida operatsiyadan keying ventral churrasi bo`lgan bemorlarni davolash uchun tavsiya etilgan algoritm operatsiyadan keying asoratlar chastotasini 11,9 % dan 4,3% gacha kamaytirishga, kompartmen sindromini rivojlanmasligiga va kasallikning qaytalanishini pasayishiga imkon berdi (asosiy guruhda va taqqoslash guruhida mos ravishda 2,4% va 6,3%).
Ventral churra bilan og'rigan 14 nafar bemorda laparoskopik gernioalloplastika natijalari keltirilgan: - kindik (6), paraumbilikal (2), qorinning oq chizig'i (6). Barcha kuzatuvlarda R0. Churra darvozasi kengligi W1-6, W2-4, W3-4. Taqqoslash guruhi ochiq usulda operatsiya qilingan, klinik jihatdan taqqoslanadigan 57 bemordan iborat edi. Asosiy guruhda operatsiya davomiyligi, operatsiyadan keyingi asoratlar, kasalxonada qolish va reabilitatsiya davomiyligi qisqargan.
Библиографические ссылки
Abdurakhmanov D. S., Rakhmanov Q. E., Davlatov S. S. Criteria for choosing surgical treatment of patients with ventral hernias and obesity //Электронный инновационный вестник. – 2021. – №. 7. – С. 57-67.
Abdurakhmanov D., Rakhmanov K., Davlatov S. Tactical and technical aspects of surgical interventions for abdominal hernias and combined abdominal pathology // Journal of Hepato-Gastroenterological Research. – 2021. 2(3). 11-16. (in Russ).
Abdurakhmanov D., Usarov Sh., Rakhmanov K. Criteria for choosing surgical treatment of patients with ventral hernias and obesity // Journal of hepato-gastroenterological studies. – 2021. 2(3). 17-22. (in Russ).
Arziev I. A. Bile outflow after cholecystomy in early postoperative period: causes and surgical correction //European research: innovation in science, education and technology. – 2021. – С. 67-69.
Arziev I. A. Improvement of surgical tactics in the correction of bile leakage after cholecystectomy using minimally invasive technologies // LXXVIII International correspondence scientific and practical conference «international scientific review of the problems and prospects of modern science and education» (Boston. USA. February 19-20, 2021)
Kurbaniyazov Z. B., Arziev I. A. Optimization of diagnosis and treatment tactics of early biliary complications after cholecystectomy //International Journal of Pharmaceutical Research (09752366). – 2020. – Т. 12. – №. 1..
Zarei L. et al. Investigating the factors affecting self-care behaviors in diabetic patients: A systematic review //Journal of Biological Research-Bollettino della Società Italiana di Biologia Sperimentale. – 2022. – Т. 95. – №. 1.
