COMPARATIVE ANALYSIS OF THE TREATMENT OF INGUINAL HERNIAS BY TRADITIONAL AND LAPAROSCOPIC METHODS TAPP - IMMEDIATE RESULTS AND COMPLICATIONS
Introduction. Operations to eliminate inguinal hernias are one of the most common in surgical practice. In recent years, laparoscopic techniques, including TAPP, have been widely used in their implementation. For more reliable recurrence prevention, a technique is proposed that involves suturing the internal inguinal ring during TAPP.
The purpose of the study is to give a comparative description of the results of various methods of inguinal hernia repair and the nature of postoperative complications depending on the method of intervention and the presence of overweight and obesity in patients.
Materials and methods. The design of the study is a randomized multicenter clinical trial. The study included 268 patients aged 18 to 84 years (mean age 59.2±10.6 years), including 46 women and 222 men. There were 187 patients with a normal body mass index, overweight - 72, obese - 9. All patients were divided into 4 groups depending on the method of intervention: open hernioplasty according to Shouldice (TAPP 29 patients), according to Lichtenstein (118), laparoscopic TAPP technique (109) and TARR- suturing the internal inguinal ring (12). Based on clinical observation data, the frequency of early postoperative complications was determined.
Research results: For all identified complications of hernioplasty, an excess of frequency was observed in the presence of overweight and obesity (χ2=4.331, p=0.038). When using hernioplasty in overweight and obese individuals, the highest rate of complications was determined. In the TAPP group, the cumulative frequency of exacerbations exceeds 6.4%; there were no manifestations that differed in the presence or absence of an excess of BMI over normal values. In the TAPP-UVPK group, there was 1 case of the disease in the presence of increased body weight, which was detected in 4.5% of the total population and 14.3% of the identified subgroups. complications with the detection of hernioplasty were significant (χ2=4.660, p=0.031) due to subgroups with increased BMI and obesity (t=0.0001).
Conclusions: 1. Laparoscopic treatment of inguinal hernias using the TAPP technique provides a significant reduction in the incidence of early postoperative complications, primarily in individuals with an increased body mass index.
2. The use of the TAPP technique with closure of the internal inguinal ring does not increase the risk of early postoperative complications.
Adlet A. Mendybaev1, https://orcid.org/0000-0002-7854-9891
Alexander B. Fursov1, https://orcid.org/0000-0002-6992-8646
Bakit A. Ismagambetova1, https://orcid.org/0000-0003-2680-1319
Timofey F. Kovalenko1, https://orcid.org/0000-0002-1782-4773
Irina S. Volchkova1, https://orcid.org/0000-0001-7792-1084
Nazarbek B. Omarov2, https://orcid.org/0000-0003-3262-1410
1 NJSC "Astana Medical University", Faculty of General Medicine, Department of Surgical Diseases, Bariatric Surgery and Neurosurgery. Astana, Republic of Kazakhstan.,
2 NJSC "Semey Medical University", Semey, Republic of Kazakhstan.
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Mendybaev A.A., Fursov A.B., Ismagambetova B.A., Kovalenko T.F., Volchkova I.S., Omarov N.B. Comparative analysis of the treatment of inguinal hernias by traditional and laparoscopic methods TAPP - immediate results and complications // Nauka i Zdravookhranenie [Science & Healthcare]. 2022, (Vol.24) 6, pp. 86-93. doi 10.34689/SH.2022.24.6.012Related publications:
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