IMPROVING THE RESULTS OF SURGICAL TREATMENT OF HERNIAS OF THE ANTERIOR ABDOMINAL WALL IN ELDERLY PATIENTS

Abstract

The aim was to study the effectiveness of new treatment tactics to improve the surgical treatment of elderly patients with hernias with a high frailty index. Patients in the control group (n=43) received traditional postoperative treatment. The main group of patients (n=49) received treatment using the method we proposed, which included: all patients had a nasogastric tube installed, central vein catheterization, infusion of broad-spectrum antibiotics, intravenous administration of colloid and crystalloid solutions, subject to stabilization of central venous pressure and blood pressure, as well as 6 hours, during which the patient is taken to surgery. In the early postoperative period in the intensive care unit, breathing exercises, early oral nutrition, the use of painkillers through an epidural catheter to relieve pain, and early motor and cognitive exercises to increase the functional activity of the brain were performed. A comparison of the results obtained in the main (n = 49) and control (n=43) groups, showed that according to the Clavien-Dindo classification, complications of classes II and III were more common in the control group. The course of the postoperative period was better in the main group. The effectiveness of our new method is confirmed by better indicators of inflammation in blood tests.