METHODS OF “NON-TIGHTENED” HERNIOPLASTY IN INGUINAL HERNIAS, AND THEIR COMPARATIVE ANALYSIS

M.D.MAJIDOV, V.V.KHSEYKHANOVA

Veterans Hospital, Makhachkala, RUSSIA

Urgency. With the use of mesh implants for plastic inguinal hernias the frequency of postoperative complications has decreased. However, this problem has not been fully resolved, especially from the point of view of mechanical reliability of fixation of the implant to various anatomical structures of inguinal area.

The aim of the study. To evaluate the effectiveness of “non-tightened” hernioplasty methods in inguinal hernias, identify positive and negative aspects of these interventions.

Materials and methods. The analysis includs 98 patients with inguinal hernias, in 31 of them (31.6%) there was observed unilateral bilateral direct inguinal hernia. In 50 (51%) cases there was performed hernioplasty by Lichtenstein method, and in 48 (49%) by Trabucco. In the latter there were used hertra- procurements with a hole of «Herniamesh» company (round tight mesh with an eccentric hole with 5 cm diameter). Prosthesis was implanted in the tissue seamlessly that is possible due to the ideal porosity of the grid.

Results and discussion. The median of the duration of hospitalization of patients that were applied the Trabucco method was 7,3-1,4 bed-days, and Liechtenstein method -8,1 ± 1,6 bed-days. Terms of activation in the two groups of patients did not differ significantly: 1,5 ± 02 and 1,8 ± 0,3, respectively. Migration of the prosthesis with the application of Trabucco method was not checked, and in Liechtenstein method was observed in - 2 (4.1%) cases. Recurrence occurred in two cases of the application of Liechtenstein method. Best results hernioplasty by Trabucco method were connected with the fact that the mesh lies flat, not shrinks, and no does not form dead spaces, which can lead to complications such as seroma, hematoma, and cases of recurrence.

Thus, the “seamless” method of plasty of the inguinal canal by using a grid-procurement is the most effective way of inguinal channels plasty in hernias of this localization.

Date: 2014-12-28; view: 1105