The diagnosis of undifferentiated connective tissue dysplasia and its role in the recurrence of incisional ventral hernia
https://doi.org/10.17238/2072-3180-2025-4-17-25
Abstract
Introduction. According to statistics, 12,8 % of patients develop an incisional hernia within 2 years after laparotomy. At the same time, the probability of hernia recurrence after hernioplasty can reach 30 %. Recently, researchers have been actively studying the relationship between connective tissue diseases, such as undifferentiated connective tissue dysplasia (UCTD), and the occurrence of hernias of the anterior abdominal wall. However, to date, no studies have been conducted that would establish a link between the phenotypic and morphological methods of diagnosing UCTD in patients with incisional ventral hernias (IVH). In addition, there is no information in the literature on how the severity of UCTD affects the risk of recurrence of incisional ventral hernias after various hernioplasty methods.
Materials and methods of research. The main group consisted of 91 patients with IVH. The control group consisted of 20 patients who underwent cholecystectomy and had a previous history of laparotomy surgery without herniation. All participants underwent a phenotypic assessment of the severity of UCTD using the Luzgina-Shkurupiya method. A morphometric study was performed in 40 patients with IVH and 20 patients from the control group.
Results. There were statistically significant differences in the number of pixels reflecting the ratio of collagen types I and III between the groups of patients with IVH and UCTD of varying severity (p<0.05). It was found that as the severity of UCTD increased, there was a significant increase in the number of IVH recurrences (p<0.05).
Conclusion. It was found that the probability of recurrence of IVH increases significantly with increasing severity of UCTD. The phenotypic method of assessing UCTD, proposed by Luzgina-Shkurupiy, corresponds to the data of morphological research and can be used as a screening method to assess the severity of UCTD in patients with IVH.
About the Authors
A. V. YurasovRussian Federation
Yurasov Anatoly Vladimirovich – Doctor of Medical Sciences, Professor, Chief Researcher of the Department of Thoracoabdominal Surgery and Oncology
119435, Abrikosovsky Lane, 2, Moscow
S. N. Gurin
Russian Federation
Gurin Sergey Nikolaevich – post-graduate student, Jr. Researcher at the Department of Thoracoabdominal Surgery and Oncology; Surgeon of the surgical department No. 1
119435, Abrikosovsky Lane, 2, Moscow;
123182, Pekhotnaya str., 3, Moscow
K. Y. Midiber
Russian Federation
Midiber Konstantin Yurievich – Cand. Sci. (Med.), Head of the Group of Pathomorphological and Immunohistochemical Studies, Reference Center for Infectious and Viral Oncopathology
117418, 3 Tsyurupy str., Moscow
A. D. Struchkova
Russian Federation
Struchkova Anastasia Dmitrievna – Cand. Sci. (Med.),, Researcher at the Department of Herniology and Reconstructive Surgery
27 Bolshaya Serpukhovskaya str., Moscow, 115093
A. P. Oettinger
Russian Federation
Oettinger Alexander Pavlovich – M.D., Ph.D., Professor, Head of the Department of Biomedical Research Organization, Chief Researcher at the Department of Experimental Surgery
117513, Ostrovityanova Street, 1, Moscow
L. M. Mikhaleva
Russian Federation
Mikhaleva Liudmila Mikhailovna – Dr. Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, Head of the Laboratory of Clinical Morphology
117418, Tsyurupy str., 3, Moscow
A. L. Shestakov
Russian Federation
Shestakov Alexey Leonidovich – Dr. Sci. (Med.), Professor. Head of the Department of Thoracoabdominal Surgery and Oncology
119435, Abrikosovsky lane, 2, Moscow
References
1. Bosanquet D.C. Ansell J., Abdelrahman T., Cornish J., Harries R., Stimpson Aet al. Systematic review and meta-regression of factors affecting midline incisional hernia rates: analysis of 14 618 patients. PloS one, 2015, v. 10, № 9, pp. e0138745. https://doi.org/10.1371/journal.pone.0138745
2. Bhardwaj P, Huayllani M.T., Olson M.A., Janis J.E. YearOver-Year Ventral Hernia Recurrence Rates and Risk Factors. JAMA Surg., 2024, v.159, № 6, рр. 651-658. https://doi.org/10.1001/jamasurg.2024.0233
3. Chang H.H., Juan Y.S., Li C.C., Lee H.Y., Chen J.H. Congenital collagenopathies increased the risk of inguinal hernia developing and repair: analysis from a nationwide population-based cohort study. Sci Rep., 2022, v. 12, № 1, рр. 2360. https://doi.org/10.1038/s41598-022-06367-5
4. Messer N., Prabhu A.S, Miller B.T., et al. Outcomes of complex abdominal wall reconstruction in patients with connective tissue disorders: a single center experience. Hernia. 2024, № 28(3), рр. 831–837. https://doi.org/10.1007/s10029-023-02957-y
5. E.V. Akatova, G.P. Arutyunov, A. A.Baranov [et al.] Clinical Guidelines. Undifferentiated connective tissue dysplasia. Therapy, 2024, vol. 10, № S5(77). pp. 1–43. (In Russ.) https://doi.org/10.18565/therapy.2024.5suppl.1-43
6. Milkovskaya-Dimitrova T. Congenital connective tissue low resistance in children. Sofia. Medicine and Physical Education, 1987. 189 р. (In Bulgarian)
7. Glesby M.J., Pyeritz R.E. Association of mitral valve prolapse and systemic abnormalities of connective tissue. A phenotypic continuum. JAMA, 1989, Jul 28, № 262(4), рр. 523–528. https://doi.org/10.1001/jama.1989.03430040095032
8. Martynov A.I., Nechaeva G.I. Clinical recommendations of the Russian Scientific Medical Society of Therapists on the diagnosis, treatment and rehabilitation of patients with connective tissue dysplasia (first revision). Medical Bulletin of the North Caucasus, 2018, № 13(1), рр. 137–209. https://doi.org/10.14300/mnnc.2018.13037 (In Russ.)
9. Rittié L. Method for Picrosirius red‐polarization detection of collagen fibers in tissue sections. Methods Mol Biol, 2017, № 1627, рр. 395–407. https://doi.org/10.1007/978-1-4939-7113-8_26
10. Patent N 2455940 Russian Federation, IPC A61B 10/00 (2006.01). Method for diagnosing the severity of undifferentiated connective tissue dysplasia syndrome: N 2010152890/14: application. 12/23/2010: publ. 07/20/2012 / Luzgina Natalia Gennadievna (RU), Shkurupiy Vyacheslav Alekseevich (RU), 9 p. https://yandex.ru/patents/doc/RU2455940C1_20120720 (In Russ.)
11. Casanova A.B., Trindade E.N., Trindade M.R. Collagen in the transversalis fascia of patients with indirect inguinal hernia: a case-control study. Am J Surg. 2009, № 198, рр. 1–5. https://doi.org/10.1016/j.amjsurg.2008.07.021
12. Bereschenko V.V., Lyzikov A.N., Shebushev N.G., Chernobayev M.I. The visual signs of connective tissue dysplasia in patients with inguinal and femoral hernia. Health and Ecology Issues, 2014, № 4, рр. 51–54. (In Russ.) https://doi.org/10.51523/2708-6011.2014-11-4-9
13. Ozdogan M., Yildiz F., Gurer A., Orhun S., Kulacoglu H., Aydin R. Changes in collagen and elastic fiber contents of the skin, rectus sheath, transversalis fascia and peritoneum in primary inguinal hernia patients. Bratisl Lek Listy, 2006, № 107(6–7), рр. 235–238.
14. Stupin V. A., Jafarov E. T., Chernyakov A.V. [et al.] Features of connective tissue in patients with postoperative ventral hernias. Bulletin of the Russian State Medical University, 2009. № 5. pp. 7–10. (In Russ.)
15. Klinge U., Si Z.Y., Zheng H., Schumpelick V., Bhardwaj R.S., Klosterhalfen B. Abnormal collagen I to III distribution in the skin of patients with incisional hernia. Eur Surg Res., 2000, v. 32, № 1, рр. 43–48. https://doi.org/10.1159/000008740
Review
For citations:
Yurasov A.V., Gurin S.N., Midiber K.Y., Struchkova A.D., Oettinger A.P., Mikhaleva L.M., Shestakov A.L. The diagnosis of undifferentiated connective tissue dysplasia and its role in the recurrence of incisional ventral hernia. Moscow Surgical Journal. 2025;(4):17-25. (In Russ.) https://doi.org/10.17238/2072-3180-2025-4-17-25

















