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Khayitov Ilkhom, assistant, department of Surgical disease for GP Tashkent Medical Academy E-mail: ilhom.med79@mail.ru
Experimental modeling hernia of anterior abdominal wall with abdomino-visceral obesity
Abstract: Improve the results of treatment of patients with postoperative ventral hernias, and based on the study of changes in the anterior abdominal wall of the experimental method of modeling To achieve this goal the first objective of the study was to develop an adequate experimental model of postoperative ventral hernias.
Keywords: experimental method of modeling of abdominal hernia, abdominoplasty, abdominal-visceral obesity.
Relevance. The treatment of postoperative ventral hernias is still a pressing problem surgery. Despite the fact that there are currently more than 240 modifications hernia plastic, the percentage of poor and bad outcomes associated with recurrence, ranging from 15.2% to 56.3% for planned operations and from 72.5% to 90.8% in emergency operations. [1, 2087-2094] Currently, modern medicine including surgery increased interest in abdominal obesity. Some scientists equate abdominal obesity and metabolic syndrome. Since the main manifestations of the metabolic syndrome are abdominal-visceral obesity. Despite the relatively well-studied features of abdomen cause-visceral obesity has not been studied in the patho-genesis of abdominal-visceral obesity in patients who had postoperative and ventral hernias. Developed countries, people with visceral obesity up to 35%, and increases with
age. Scientists provides interesting facts, that the incidence of metabolic syndrome, depending on the membership of a particular ethnic group. [2, 263-270] In our study, patients with postoperative ventral hernias and who had belly droops more common in urban areas.
At the present time we are faced with an epidemic of obesity in the world. Early diagnosis of metabolic syndrome — is primarily prevention ofclinical manifestations of type 2 diabetes and atherosclerotic vascular disease. [3, 62-67] In many cases, the disease is detected during the clinical manifestation, as the disease is often asymptomatic, and in the early period revealed only methods Other laboratory diagnostics. [4, 460-468] Currently, most doctors and scientists do not consider abdominal obesity as a specific form of the disease, in spite of the large number of works, there are many controversial issues. On this
despite the progress made in minimally invasive surgery a problem of modern surgery. Summarizing all the above, and the incidence of postoperative ventral hernias espe- we studied the effect of hernia of anterior abdominal wall cially in patients with abdominal visceral obesity remains to the abdominal-visceral obesity [5, 15-35].
Manual ATP III (Adult Treatment Pannel) 2001 (USA) — the presence of any 3 of the following facts
Risk Factor Diagnostic level Risk Factor Diagnostic level
abdominal obesity Waist circumference: men. > 102 cm and women> 88
Triglycerides > 1.7 mmol/l (150 mg/dl)
Cholesterol-lipoproteins high density Men <1.0 mmol/l (<40 mg/dl) Women <1.2 mmol/l (<50 mg/dl)
Arterial pressure > 130/85 mm Hg
glycemia >6.1 mmol/L (> 1 10 mg/dl)
The purpose of this study — to improve the results of treatment of patients with postoperative ventral hernias, and based on the study of changes in the anterior abdominal wall of the experimental method of modeling to achieve this goal the first objective of the study was to develop an adequate experimental model of postoperative ventral hernias.
Material and Methods. The experiments were performed on 36 rabbits breed "chinchilla" weighing 1850 to 2500 g. For the study animals were selected without external signs of the disease and passed quarantine vivarium conditions of the Tashkent Medical Academy. Rabbits were divided into three groups.
The first group (control tabl № 1) 12 rabbits in which artificial hernia of anterior abdominal wall were caused. Under ether inhalation anesthesia the
animals were fixed, the skin of the anterior abdominal wall treated with chlorhexidine. Strictly in the midline from the xiphoid process in a direction to the heart ripped skin, subcutaneous tissue, forming a slit length of about 6.0 cm. The length of the dissected aponeurosis was 5.0 cm. Then, on a defect of the skin wound edge stitched continuous filament. All the rabbits operated well tolerated intervention. After the animals were kept under natural operation conditions of the vivarium, fed a normal feed. Immediately after surgery, the rabbits appeared hernia defect that after 5 days is clearly visible protrusion, and further increased to 10 days. Thus, the proposed surgical technique allows you to get the classic version of the formation of postoperative ventral hernias, which can be used to study the pathogenesis of this disease.
№ The initial weight and age Weight at 1 month, and the amount of hernias Weight in 2 months, and the size of hernias
1 2350 gr/5month 2550 gr/4x5 sm 2650 gr/4x5 sm
2 2300 gr/5,5 month 2500 gr/4,5x5 sm 2600 gr/4,5x5 sm
3 2200 gr/5 month 2450 gr/4x4 sm 2600 gr/4x4 sm
4 2400 gr/5,5 month 2550 gr/4x5 sm 2650 gr/4x5 sm
5 2050 gr/4,5 month 2300 gr/3,5x4 sm 2600 gr/3,5x4 sm
6 2250 gr/5 month 2500 gr/3,5x4,5 sm 2700 gr/3,5x4,5 sm
7 2200 gr/5 month 2450 gr/4x5 sm 2650 gr/4x5 sm
8 2100 gr/5 month 2350 gr/4,5x4,5 sm 2750 gr/4,5x4,5 sm
9 2300 gr/5,5 month 2450 gr/4x5 sm 2650 gr/4x5 sm
10 2200 gr/4,5 month 2500 gr/3,5x4 sm 2600 gr/3,5x4 sm
11 2050 gr/5 month 2350 gr/3,5x4 sm 2750 gr/3,5x4 sm
12 2150 gr/5 month 2400 gr/4x5 sm 2600 gr/4x5 sm
Total 26550/2212,5 29350/2445,833 31800/2650
2nd group of 12 rabbits. This group of healthy rabbits without any pathology. Only they are kept in small cages, in order to create inactivity. The animals drinkers was 5%
sugar solution was subcutaneously administered insulin at a dose of 0.1 U/100 g, a day. (tabl № 2).
Table 2.
№ The initial weight and age Weight after 1 month Weight after 2 month
1 2 3 4
1 2350 gr/4,5 month 3200 gr 3650 gr
3rd group of12 rabbits who also have been caused by The animals drinkers was 5% sugar solution was artificial hernia of anterior abdominal wall. Animals in subcutaneously administered insulin at a dose of this group were kept in small cages, to create inactivity. 0.1 U/100 g, a day. (tabl № 3).
Table 3.
1 2 3 4
2 2400 gr/6 month 3300 gr 3750 gr
3 2200 gr/5 month 3150 gr 3700 gr
4 2350 gr/5,5 month 3350 gr 3800 gr
5 2150 gr/5 month 3300 gr 3850 gr
6 2350 gr/5 month 3250 gr 3750 gr
7 2200 gr/4,5 month 3400 gr 3700 gr
8 2100 gr/5 month 3350 gr 3850 gr
9 2300 gr/5,5 month 3450 gr 3600 gr
10 2350 gr/5 month 3500 gr 3700 gr
11 2100 gr/4,5 month 3400 gr 3850 gr
12 2250 gr/5,5 month 3200 gr 3750 gr
Total 27100/2258,333 39850/3320,83 44950/3745,833
№ The initial weight and age Weight after 1 month Weight after 2 month
1 2300 gr/5,5 month 3500gr/6x5 sm 3900gr/7x6 cm
2 2250 gr/5 month 3550 gr/7x8 sm 3950 gr/6x7 cm
3 2450 gr/5 month 3500 gr/7x7 sm 4000 gr/9x10 cm
4 2300 gr/4,5 month 3450 gr/7x8 sm 3950 gr/9x8 sm
5 2100 gr/5 month 3500 gr/7x7 sm 3900 gr/9x9 sm
6 2300 gr/5,5 month 3450 gr/7x8 sm 4150 gr/9x10sm
7 2350 gr/4,5 month 3600 gr/6x7 sm 4050 gr/10x10sm
8 2400 gr/6 month 3500 gr/6x6 sm 4100 gr/9x9 sm
9 2200 gr/5 month 3550 gr/7x7 sm 4150 gr/8x9sm
10 2300 gr/5 month 3600 gr/7x8 sm 4100gr/9x8 sm
11 2150 gr/4,5 month 3650 gr/5x6 sm 3950 gr/8x8 sm
12 2250 gr/5 month 3550 gr/6x7 sm 3900 gr/8x9 sm
Total 27350/2280 42400/3533,33 48100/4008,33
In all groups, the animals for a month after the formation of hernias recorded weight gain and lipid content of the blood.
The results showed that after 1 month, body weight gain in group 3 rabbits was 106.5% compared with group 2. The initial level of the second group than a month there is a tendency to an increase in body weight
Our studies have shown, by experiment was modeled postoperative ventral hernia in rabbits abdomino-visceral obesity. The proposed method is simple, does not require much effort. It can be seen on its basis for the disease, since the effect of abdominal-visceral obesity on the size of hernial ring and the volume of content.
Conclusions: In the simulation of postoperative ventral hernias with abdomino-visceral obesity
gain. But the growth of this group in comparison with the third group were statistically insignificant.
The results showed that after a month weight gain in rabbits 2nd group was 135.5% compared to the 1st group. body weight gain in rabbits 3rd group was 144.6%. compared with the first group.
hernial contents increases, with an increase in body weight (third group). The first group of animal weight gain amounted to ± 200 gr/per month, the amount of hernias and hernia gate slightly decreases in size, as in the third group of postoperative ventral hernia with abdomino-visceral obesity hernial contents increased ± 3 cm, with an increase in body weight ± 1200 gr/per month.
Group of animals The initial weight and age Weight after 1 month Weight after 2 month
1 control 26550/2212,5 29350/2445,833 31800/2650
2 alimentary 27100/2258,333 39850/3320,83 44950/3745,833
3 basic alimentary 27350/2280 42400/3533,33 48100/4008,33
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