MODERN APPROACH TO SURGICAL TREATMENT OF VENTRAL HERNIA AFTER ANTERIOR ABDOMINAL WALL OPERATION: A SYSTEMATIC LITERATURE REVIEW

Objective: To analyze modern methods of surgical treatment of postoperative ventral hernias of the anterior abdominal wall (POV) and determine optimal treatment strategies. Materials and methods: A systematic literature search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, and eLIBRARY databases for the period 2015-2024. The following keywords were used in the search strategy: "incisional hernia", "ventral hernia", "mesh repair", "laparoscopic hernia repair", "component separation". 161 sources that met the quality criteria were included in the analysis. Results: OCCH develops in 11-20% of patients undergoing laparotomy, and after emergency operations this figure reaches 23-35%. Comparative analysis of hernioplasty techniques shows that the recurrence rate after autoplasty with local tissues is 40-63%, onlay alloplasty 12-24%, sublay/retromuscular technique 4-15%, laparoscopic IPOM 4-8%, and transversus abdominis release (TAR) 2-8%. Laparoscopic approach reduces the risk of wound infection by 72% (2.9% vs 10.5%, p<0.001) and the length of hospital stay by 54% (2.5 vs 5.8 days, p<0.001) compared to the open method. For large and giant hernias, the TAR technique gives the best results. Using ERAS protocols reduces complications by 28% and hospital stay by 35%. Conclusion: Mesh alloplasty is considered the "gold standard" in modern OCH surgery. The choice of the optimal technique depends on the size, location, patient factors, and surgeon experience. Laparoscopic IPOM is recommended for small hernias, sublay or laparoscopic IPOM for medium hernias, and TAR for large hernias. Comprehensive preventive strategies (patient optimization, ERAS protocols) significantly reduce complications.