TESTICULAR PERFUSION AND INFLAMMATORY REACTION IN THE COMPARATIVE EVALUATION OF HERNIOPLASTY
Background. Сomparative evaluation of the inflammatory response and testicular perfusion of a new modified method of autoplasty with a displaced aponeurotic flap and Lichtenstein hernioplasty using immunological markers and ultrasound.
Materials and methods. 60 patients were operated on with a diagnosis of uncomplicated inguinal hernia, of which 30 patients were operated on by a new autoplasty method, the comparison group - Lichtenstein hernioplasty using a partially absorbable mesh implant (UltraPro) - 30 patients. To clarify the changes in the immunological markers of inflammatory process activity, the level of C-reactive protein (CRP), tumor necrosis factor (TNF) and interleukin-2 (IL-2) was determined by the enzyme immunoassay test. Ultrasound was used to assess the presence/absence of inflammatory infiltrate, blood flow, and tissue density of the "zone of interest".
Results. Patients from the comparison group had higher serum levels of C-reactive protein and interleukin-2 than patients operated on by inguinal canal autoplasty. TNF levels did not differ statistically significantly in both groups. According to ultrasound data, there was no inflammatory infiltrate in the group using the new autoplasty method. Blood flow in the testicular, capsular and intratesticular arteries in both groups improved, statistically significantly differed, but in later periods in the comparison group was lower than basal values. According to compression elastography in the postoperative area, the formation of a denser scar was in the comparison group with a statistically significant difference.
Conclusion. The main negative aspects of the use of mesh implants, based on our study, are the formation of inflammatory infiltrate, increased tissue density and dense scars in the postoperative area according to radiation research methods, correlating with the indicators of immunological markers of blood. The use of a modified autoplasty method has great potential in modern herniology, and this will eliminate complications arising from the use of synthetic endoprostheses.
Makash T. Aliyakparov1, https://orcid.org/0000-0002-9276-3966
Nurkasi T. Abatov1, https://orcid.org/0000-0002-4111-6355, Scopus Author ID: 57041293300
Saule T. Sapieyva1, https://orcid.org/0000-0002-0850-2377
Ruslan M. Badyrov1, https://orcid.org/0000-0002-3578-7144
Аsем Z. Аringazieva,
Elena S. Badyrova1,
1 NCJSC «Karaganda Medical University», Karaganda c., Republic of Kazakhstan.
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Aliyakparov M.T., Abatov N.T., Sapieyva S.T., Badyrov R.M., Аringazieva А.Z., Badyrova E.S. Testicular perfusion and inflammatory reaction in the comparative evaluation of hernioplasty // Nauka i Zdravookhranenie [Science & Healthcare]. 2022, (Vol.24) 6, pp. 94-100. doi 10.34689/SH.2022.24.6.013Related publications:
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