10-YEARS EXPERIENCE IN PERFORMING INGUINAL HERNIA SURGICAL TREATMENT USING MESHES P. 78-83

V.G. MISHALOV, A.O. BURKA, L.Yu. MARKULAN, S.M. GOYDA, O.V. BALABAN, I.M. LESCHISHIN, I.I. TESLYUK

Анотація


Problem of treating patients with inguinal hernia is actual -
frequency of recurency remains high: 6,2-10,2% after
primary and 12-16% after secondary hernioplasty. The goal
of the research was to estimate the results of different ways
of treating patients with inguinal hernias, to find out the
reasons of bad results of treating patients with this pathology,
to work out a complex of practical recommendations for
preventing complications and improving the results of
treating patients with inguinal hernias. The results of surgical
procedures in patients with inguinal hernias performed in
the period from 1999 till 2008 were analyzed. From 1030
patients with this pathology 916 (88,9 %) were men and 114
(11,1 %) were women. The age of the patients ranged from
16 to 93 years, mean age 48,7 years. Nyhus (1993)
classification of inguinal hernias was used in the research
work. Primary hernias were registered in 875 (85 %),
recurency - in 155 (15 %) cases. 81 (7,9 %) patients with
inguinal hernias had urgent operations for hernia
incarceration. The inguinal canal plasty operations with the
use of the patients own tissues were performed in most cases
using Bassini, Girard-Spasokukotskiy and Postempskiy
methods, the plastic operations with the use of cellular
allografts - using Lichtenstein and Stoppa methods.
Polypropylene endoprostheses of firms Ethicon and Lintex
were used as cellular prosthetic devices. Inguinal hernias of
the Ist type according to Nyhus (1993) classification were
registered in 45 (4.4 %) patients, of the IInd type - in 259
(25.1 %), of the IIIrd A type - in 384 (37.3 %), of the IIIrd B
type - in 141 (13,7 %), of the IIIrd A, B type - in 46 (4.5 %),
of the IVth type - in 155 (15 %) patients. Sliding hernias
were find in 158 (15,3 %) cases of our research. Bilateral
inguinal hernias were diagnosed in 56 (5,4 %) patients.
Single-stage surgical procedures were performed in 37
patients, two-stage procedures - in 19. The estimation of the
results of treating patients with inguinal hernias was
performed by comparing intraoperative, early and late
postoperative complications. The results of treating patients
with inguinal hernias proved the advantages of usage cellular

transplants while conducting hernioplasty, in particular, the
number of autoplasty complications reached 17.5 % while
the number of alloplasty complications was 8.5 %. The causes
of certain unsatisfactory results of treating patients with this
pathology were the wrong choice of the ways of inguinal
canal plasty (6 %) and technical mistakes during the
operations (1.6 %). The improvement of therapy results, in
our opinion, is connected with the individual approach to
the choice of the ways of inguinal canal plasty operations
rather than with the more widely application of allograft ways
of hernioplasty. Such individual approach is possible only if
the surgeons can perform different methods of surgical
procedures including those which use cellular polypropylene
prosthetic devices.
Key words: inguinal hernias, surgical treatment, postoperative
complications


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Грубник В.В., Лосев А.А., Баязитов Н.Р., Парфентъев

Р.С. Современные методы лечения брюшных грыж. -

К.: "Здоров'я". - 2001. - 278 с.

Жебровский В.В. Ранние и поздние послеоперационные

осложнения в хирургии органов брюшной полости.

- Изд. центр КГМУ, Симферополь. - 2000. - 687 с.

Фелештинский Я.П. Патогенез, хірургічне лікування і

профілактика рецидивів гриж черевної стінки у паці-

єнтів похилого і старечого віку.: Автореф. дисертації

на здобуття наукового ступеня доктора медичних наук.

- Київ. - 2000. - 35 с.

Lichtenstein I.L., Shulman A.G., Amid P.K. Twenty

quesnios about Hernioplasty // Am. Surg. - 1991. - Vol.

- ¹ 11. - P. 730-733.

Nyhus L.M., Condon R.E. Hernia. - Philadelphia J.B.

Lippincott Co, 1995. - 615 p.

Stoppa R.E., Soler M. Chemistry, geometry and physics

of mesh materials // Expert meeting on hernia surgery (St.

Moritz, 1994). - Basel: Karger, 1995. - P. 166-171.


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