METHOD OF TREATMENT FOR RECURRENT INGUINAL HERNIAS
Introduction: Despite modern achievements in herniology and the availability of a large number of methods of surgical treatment of inguinal hernia, surgical treatment of hernias of the anterior abdominal wall is still an urgent problem in abdominal surgery, which is caused by a high rate of complications and recurrences in the long-term period of 5-47%.
In patients with recurrent inguinal hernias during the operation, there are difficulties with changing the anatomical structures, cicatricial processes in the tissues, the appearance of a sliding form of a crack, n. ilioinguinalis and is based on the risk of damage to the reproductive zone, all this requires the invention of a special method for performing the operation [5, 16].
Based on the above questions, in order to improve the results of surgical treatment of patients with postoperative recurrent inguinal hernias, which served as the basis for the study, further clinical research is needed.
Aim of the study: Analysis of the results of surgical methods for the treatment of recurrent inguinal hernias using non-stretch hernioplasty according to the clinical method.
Materials and research methods: Analysis of the results of surgical treatment of 158 patients admitted in the period from 2013 to 2020 to the Department of Adult Surgery at the Department of Hospital and Pediatric Surgery of the University Hospital of the Non-Commercial Joint Stock Company "Semey Medical University" (UG NJSC "IUS"). The age of patients ranged from 24 to 74 years, the mean age was 58.8 ± 5.2. The duration of carriage of recurrent inguinal hernias in patients ranged from 9 months to 12 years. Right-sided location of hernias was found in 83 (52.6%) patients, left-sided - in 62 (39.2%) and bilateral - in 13 (8.2%) patients. All patients, depending on the application of the alloplasty method of non-stretch hernioplasty, were divided into the main and control groups.
Results: The evaluation of the results of the study was carried out depending on the nature of the surgical intervention, postoperative pain syndrome, motor activity, tissue edema in the area of the postoperative suture, bed days in the hospital, and the presence of complications. These criteria were prioritized based on the operations of patients with inguinal hernia. The average duration of the operation was 48.3±2.2 minutes. According to our study, the average bed-days of patients operated on by non-stretch hernioplasty according to the clinic method was 7.4+0.8 days, and the average bed-days of patients operated on by the Liechtenstein non-stretch hernioplasty method in the control group was 9.5+1,1 day.
Conclusions: The complication rate after non-stretch hernioplasty using the Lichtenstein method was 22.5%, and the complication of hernia repair from non-stretch hernioplasty using the clinic method was 9%.
When analyzing long-term results, very good results in the group are 2.2 times higher than in the control group. Also in the clinic, an improved non-stretch hernioplasty prevents the appearance of a hernia in the hips.
Meyrbek Zh. Aimagambetov1, https://orcid.org/0000-0003-4699-8200
Medet A. Auyenov1, https://orcid.org/0000-0002-1809-9091
Samatbek T. Abdrakhmanov1, https://orcid.org/0000-0002-4270-3498
Nazarbek B. Omarov1, http://orcid.org/0000-0002-6201-8263
Есенгазы О. Масалимов1, https:// orcid.org/0000-0001-6236
Rinat K. Taiburov2, https://orcid.org/0000-0002-1404-0949
Аldiyar Y. Мasalov1, https://orcid.org/0000-0003-3386-1416
Yerasyl A. Mukash1, https://orcid.org/0000-0002-3337-7643
Shyngys O. Orynbasarov3, https:// orcid.org/0000-0002-9321-1426
1 Department of Hospital and Pediatric Surgery, NСJSC «Semey Medical University»,
Semey, Republic of Kazakhstan;
2 University Hospital NСJSC «Semey Medical University», Semey, Republic of Kazakhstan;
3 Military Department, NСJSC «Semey Medical University», Semey, Republic of Kazakhstan.
1. Акимов В.П., Крикунов Д.Ю., Паршин Д.С. и др. Возможности использования клеевого метода фиксации сетчатого импланта при лапароскопическом лечении паховых грыж // Таврический медико-биологический вестник. 2018. T.21, №1. С. 7-14.
2. Белоконев В.И., Гогия Б.Ш., Горский В.А., Ермаков Н.А. и др. Паховые и послеоперационные грыжи. Национальные клинические рекомендации по герниологии. Серпухов, 2018; 101 с.
3. Гаар Е.В., Гаар В.Г., Проценко Д.С. и др. Анализ рецидивов паховых грыж после ненатяжной герниопластики по Лихтенштейну // Вятский медицинский вестник. 2018. №3. С.12-13.
4. Климов А.Е., Попов В.С., Бархударов А.А., Юрий A.В. Выбор сетчатого имплантанта для пластики Lichtenstein у мужчин репродуктивного возраста // Вестник Российского университета дружбы народов. Серия: Медицина. 2018. 22 (3): 249–57. DOI: 10.22363/2313–0245–2018–22–3-249–257
5. Крайнюков П.Е., Скоробогатов В.М., Черных В.Г., Кулюшина Е.А., Бондарева Н.В. Способ комбинированной аллопластики при косой паховой грыже // Вестник Национального медико-хирургического центра им. Н.И. Пирогова. 2017. 12 (4–2). С.47–51.
6. Лесников С.М., Павленко В.В., Подолужный В.И., и др. Современная концепция генеза и лечения грыж паховой области (обзор литературы) // Вопросы реконструктивной и пластической хирургии. 2019. №1. С. 68-75.
7. Поборский А.Н., Дрожжин Е.В., Асутаев Ш.Д. Анализ «Затраты-полезность» лечения паховых грыж ненатяжными методами // Клиническая и экспериментальная хирургия. 2018. Т.6, №2. С. 20-25.
8. Раимханов А.Д. и др. Результаты хирургического лечения больших и рецидивных паховых грыж с применением ненатяжной герниопластики // Аллергология и иммунология. 2014. Том15, №1. С.56-57.
9. Раимханов А.Д. и др. Совершенствование способа хирургического лечения больших пахово-машоночных и рецидивных паховых грыж // Сборник научных трудов по итогам международной научно-практической конференции: Актуальные вопросы медицины в современных условиях. 2016. №3. С.153-155.
10. Раимханов А.Д. и др. Способ герниопластики при больших и рецидивных паховых грыжах. Инновационный патент Республики Казахстан № 28996; МПК A61B 17/00; опубл. 15.10.2014.
11. Собенников И.С., Жиборев Б.Н., Котанс С.Я., Черенков А.А. Диагностика и лечение мужского бесплодия у больных распространенной патологией гениталий и паховой области // Российский медико-биологический вестник им. академика И.П. Павлова. 2017. 25 (3): 460–4. DOI: 10.23888.
12. Харитонов С.В., Родоман Г.В., Харитонов С.С. Особенности интенсивности и локализации боли в раннем послеоперационном периоде у больных с паховыми грыжами после выполнения различных типов герниопластики // Эндоскопическая хирургия. 2019. Т.25, №2. С.26-34.
13. Andercou O., Olteanu G., Stancu B., et al. Risk factors for and prevention of chronic pain and sensory disorders following inguinal hernia repair // Annali italiani di chirurgia. 2019. Vol.8. Р.442-446.
14. Ates E., Kazici H.G., Amasyali A.S. A rare complication of inguinal hernia repair: Total testicular ischemia and necrosis. Arch Ital Urol Androl. 2019 Mar 29. 91 (1):46–48. DOI: 10.4081/aiua.2019.1.46
15. Benlice C.A., Bilgin I.A., et al. Laparoscopic Totally Extraperitoneal vs Robotic Transabdominal Preperitoneal Inguinal Hernia Repair: Assessment of Short and Long term Outcomes // The International Journal of Medical Robotics and Computer Assisted Surgery. 2020. P. 2111.
16. Demiray O., Gonullu D., Gedik M.L., et al. Effects of suture tecnique on mesh shrinkage // Asian journal of surgery. 2019. Vol.42, №1. Р.224-227.
17. Dong Z., Kujawa S.A., Wang C., Zhao H. Does the use of hernia mesh in surgical inguinal hernia repairs cause male infertility? A systematic review and descriptive analysis // Reprod Health. 2018. Apr 23. 15 (1):69. DOI: 10.1186/s12978–018–0510-y
18. Furtado M., Claus C.M.P., Cavazzola L.T., Malcher F., Bakonyi-Neto A., Saad-Hossne R. Systemaization of lapaproscopic inguinal hernia repaip (TAPP) based on a new anatomical concept: inverted Y and five triangles. Arq Bras Cir Dig. 2019 Feb 7;32 (1): e1426.DOI: 10.1590/0102–672020180001e1426
19. Guo W., Hu M., Huang R., Wang H. Hundred years development and future prospect of the material science for hernia // Chinese journal of gastrointestinal surgery. 2018. Vol.21, №7. Р. 828-832.
20. Heymann F., von Trotha K.T., Preisinger C., Lynen-Jansen P., Roeth A.A., Geiger M., et al. Polypropylene mesh implantation for hernia repair causes myeloid cell-driven persistent inflammation // JCI Insight. 2019 Jan 24;4 (2). pii: 123862. DOI: 10.1172/jci. insight.123862
21. Huerta S. Inguinal hernia repair in centers of excellence. Hernia. 2019 Jul 5.DOI: 10.1007/s10029–019–01998–6
22. Ielpo B., Duran H., Diaz E., et al. A prospective randomized study comparing laparoscopic transabdominal preperitoneal (TAPP) versus Lichtenstein repair for bilateral inguinal hernias // The American Journal of Surgery. 2018. Vol.216, №1. P.78-83.
23. Ivakhov G., Kolygin A., Titkova S., et al. Development and evaluation of a novel simulation model for transabdominal preperitoneal (TAPP) inguinal hernia repair // Hernia. 2020. Vol.24, №1. Р. 159-166.
24. Kohl A.P., Andresen K., Rosenberg J. Male Fertility After Inguinal Hernia Mesh Repair A National Register Study. Ann Surg. 2018 Aug. 268 (2): 374–378. DOI: 10.1097 /SLA.0000000000002423
25. Nyhus L.M., Condon R.E. Hernia // J.B. Lipponcott Company, Philadelphia, -1995.- 615 р.
26. Nyhus L.M. Meshes: benefits and risks // Springer: Heidelberg. 2004. 469 р.
References [1-12]:
1. Akimov V.P., Krikunov D.Ju., Parshin D.S., i dr. Vozmozhnosti ispol'zovaniya kleevogo metoda fiksatsii setchatogo implanta pri laparoskopicheskom lechenii pakhovykh gryzh [Possibilities of using the adhesive method of fixation of a mesh implant in laparoscopic treatment of inguinal hernias]. Tavricheskii mediko-biologicheskii vestnik [Tavrichesky medico-biological bulletin]. 2018. T.21, №1. рр. 7-14. [in Russian]
2. Belokonev V.I., Gogija B.Sh., Gorskij V.A., Ermakov N.A., i dr. Pakhovye i posleoperatcionnye gryzhi. Natsional'nye klinicheskie rekomendatsii po gerniologii [Inguinal and postoperative hernias. National clinical guidelines for herniology] Serpukhov, 2018. 101 р. [in Russian]
3. Gaar E.V., Gaar V.G., Procenko D.S., i dr. Analiz retsidivov pakhovykh gryzh posle nenatyazhnoi gernioplastiki po Likhtenshteinu [Analysis of recurrent inguinal hernias after non-protracted hernioplasty by Liechtenstein]. Vyatskii meditsinskii vestnik [Vyatka Medical Bulletin]. 2018. №3. рр.12-13. [in Russian]
4. Klimov A.E., Popov V.S., Barhudarov A.A., Jurij A.V. Vybor setchatogo implantanta dlya plastiki Likhtenstein u muzhchin reproduktivnogo vozrasta [The choice of a mesh implant for Lichtenstein plastic surgery in men of reproductive age]. Vestnik Rossiiskogo universiteta druzhby narodov. Seriya: Meditsina [Bulletin of the Peoples' Friendship University of Russia. Series: Medicine]. 2018. 22 (3): 249–57. DOI: 10.22363/2313–0245–2018–22–3-249–257 [in Russian]
5. Krajnjukov P.E., Skorobogatov V.M., Chernyh V.G., Kuljushina E.A., Bondareva N.V. Sposob kombinirovannoi alloplastiki pri kosoj pahovoj gryzhe [Method of combined alloplasty for oblique inguinal hernia]. Vestnik Nacio-nal'nogo mediko-hirurgicheskogo centra im. N. I. Pirogova [Bulletin of the National Medical and Surgical Center named after N.I. Pirogov.]. 2017. 12 (4–2): 47–51. [in Russian]
6. Lesnikov S.M., Pavlenko V.V., Podoluzhnyj V.I., i dr. Sovremennaya kontseptsiya geneza i lecheniya gryzh pakhovoi oblasti (obzor literatury) [Modern concept of genesis and treatment of inguinal hernias (literature review)]. Voprosy rekonstruktivnoi i plasticheskoi khirurgii [Questions of reconstructive and plastic surgery]. 2019. №1. рр. 68-75. [in Russian]
7. Poborskij A.N., Drozhzhin E.V., Asutaev Sh.D. Analiz «Zatraty-poleznost'» lecheniya pakhovykh gryzh nenatyazhnymi metodami [Analysis of the "Cost-utility" of treatment of inguinal hernias by non-stretching methods]. Klinicheskaya i eksperimental'naya khirurgiya [Clinical and experimental surgery]. 2018. T.6, №2. рр.20-25. [in Russian]
8. Raimhanov A.D. i dr. Rezul'taty hirurgicheskogo lechenija bol'shih i recidivnyh pahovyh gryzh s primeneniem nenatjazhnoj gernioplastiki [The results of surgical treatment of large and recurrent inguinal hernias with the use of non-protracted hernioplasty]. Allergologiya i immunologiya [Allergology and immunology]. 2014. Tom 15, №1. рр. 56-57. [in Russian]
9. Raimhanov A.D. i dr. Sovershenstvovanie sposoba khirurgicheskogo lecheniya bol'shikh pakhovo-mashonochnykh i retsidivnykh pakhovykh gryzh [Improving the method of surgical treatment of large inguinal and recurrent inguinal hernias]. Sbornik nauchnykh trudov po itogam mezhdunarodnoi nauchno-prakticheskoi konferentsii: Aktual'nye voprosy meditsiny v sovremennykh usloviyakh [Collection of scientific papers on the results of the international scientific and practical conference: Topical issues of medicine in modern conditions]. 2016. №3. рр. 153-155. [in Russian]
10. Raimhanov A.D. i dr. Sposob gernioplastiki pri bol'shikh i retsidivnykh pakhovykh gryzhakh. Innovatsionnyi patent Respubliki Kazakhstan [A method of hernioplasty for large and recurrent inguinal hernias. Innovation Patent of the Republic of Kazakhstan], №28996. MPK A61B 17/00. opubl. 15.10.2014. [in Russian]
11. Sobennikov I.S., Zhiborev B.N., Kotans S.Ja., Cherenkov A.A. Diagnostika i lechenie muzhskogo besplodija u bol'nyh rasprostranennoj patologiej genitalij i pahovoj oblasti [Diagnosis and treatment of male infertility in patients with common pathology of the genitals and inguinal region]. Rossiiskii mediko-biologicheskii vestnik im. akademika I.P. Pavlova [Russian Medico-Biological Bulletin named after academician I.P. Pavlov]. 2017. 25 (3):460–4. DOI: 10.23888 [in Russian]
12. Haritonov S.V., Rodoman G.V., Haritonov S.S. Osobennosti intensivnosti i lokalizacii boli v rannem posleoperacionnom periode u bol'nyh s pahovymi gryzhami posle vypolnenija razlichnyh tipov gernioplastiki [Features of the intensity and localization of pain in the early postoperative period in patients with inguinal hernias after performing various types of hernioplasty]. Endoskopicheskaya khirurgiya [Endoscopic surgery]. 2019. T.25, №2. рр.26-34. [in Russian]
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Aimagambetov M.Zh., Auyenov M.A., Abdrakhmanov S.T., Omarov N.B., Масалимов Е.О., Taiburov R.K., Мasalov А.Y., Mukash Ye.A., Orynbasarov Sh.O. Method of treatment for recurrent inguinal hernias // Nauka i Zdravookhranenie [Science & Healthcare]. 2021, (Vol.23) 6, pp. 111-122. doi 10.34689/SH.2021.23.6.013Related publications:
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