The surgical treatment of postoperative ventral hernias (PVH) in patients with high operative-anesthesiologic risk (OAR) still remains a problem. The results of PVH treatment in 150 patients with different degrees of OAR are analyzed in the paper. Autoplastic operations and explantation of synthetic prostheses were performed. The second method demonstrated a range of advantages. The necessity of widening the indications for the planned surgery for PVH is proved, especially in patients with the increased OAR. This will permit avoiding complications of the hernia itself and decrease the frequency of urgent PVH surgery, very undesirable in such patients. The algorithm of the choice of reconstruction and anesthetic management is worked out.

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