Novosti
Khirurgii

 This journal is
indexed in Scopus
journal cover
android icon Android Applicaion

Year 2016 Vol. 24 No 6

GENERAL & SPECIAL SURGERY

O.V. SHULYARENKO

COMPARISON OF TOTAL EXTRAPERITONEAL AND TRANSABDOMINAL PREPERITONEAL INGUINAL HERNIAPLASTY

National Medical Academy of Post-graduate Education named after P.L. Shupyk, Ministry of Health, Kiev. Ukraine

Objectives. To compare the early results of total extraperitoneal and transabdominal preperitoneal primary herniaplasty.
Methods. Treatment results of patients (n=47) operated on in the clinic of the department of surgery and vascular surgery (2014-2016) due to the unilateral primary uncomplicated hernia have been analyzed. All patients (males) are divided into two groups: the 1st (n=25) group – the total extraperitoneal inguinal hernia repair by the developed method has been performed, the 2nd (n=22) group – the transabdominal preperitoneal herniaplasty has been made. The patients’ age varied from 20 to 61 years, the average age in the 1st group was 39,3 years, in the 2nd – 38,1.
Results. In the 1st group an average operation time made up 36,4 minutes, in the 2nd – 37,8. The level of pain syndrome according to the Visual Analogue Scale for Pain was 1,8 scores in the first group, 2,3 scores – in the second one. The pain syndrome which requires non-narcotic analgesics lasted 2,3 days in the 1st group and 2,5 days in the 2nd one. There were no indications for narcotic analgesics. In the 1st group the good early results were observed in 21 (84%) patients, satisfactory – in 4 (16%), in the 2nd group the good early results were registered in 11 (50%), satisfactory – in 11 (50%) patients.
Conclusion. The proposed method of the total extraperitoneal inguinal herniaplasty is considered to be an operation of choice for inguinal hernias (2, 3A and 3B types) based on the Nyhus classification. The good early results were 34% higher in the total extraperitoneal inguinal herniaplasty group than in the transabdominal preperitoneal primary herniàplasty group.

Keywords: inguinal hernia, herniaplasty, mesh, surgery, operation, early results, pain syndrome, Nyhus classification
p. 546-550 of the original issue
References
  1. Aver'ianov MIu, Gaar EV, Gorokhov VN. Sravnitel'nyi analiz primeneniia nenatiazhnykh i traditsionnykh sposobov gernioplastiki pri gryzhakh zhivota [Comparative analysis of the use of tension-free and the traditional methods of hernioplasty with abdominal hernias]. Sovrem Tekhnologii v Meditsine. 2011;(3):39-43.
  2. Vinnik IS, Petrushko SI, Gorbunov NS, Nazar'iants IuA. Operativnoe lechenie gryzh perednei briushnoi stenki [Surgical treatment of hernias of the anterior abdominal wall]. Krasnoiarsk, RF; 2011. 260 p.
  3. Saclarides TJ, Myers JA, Millican KA, eds. Common surgical diseases: an algorithmic approach to problem solving. 3-rd ed. New York, US: Springer; 2015. 363 p.
  4. Nikolaev NE, Alekseev SA. Klassifikatsiia, etiopatogenez i vybor sposobov khirurgicheskogo lecheniia pakhovoi gryzhi [Classification, etiopathogenesis and the choice of methods of surgical treatment of inguinal hernia]. Zdravookhranenie. 2014;(12):36-39.
  5. Vizgalov SA, Smotrin SM. Pakhovye gryzhi: sovremennye aspekty etiopatogeneza i lecheniia [Inguinal hernia: current aspects of pathogenesis and treatment]. Zhurn Grodn Gos Med Un-ta. 2010;(4):17-22.
  6. Pinevich DL, Sukonko OG, Poliakova SL, Smirnov VM, Minich AA. Printsipy «khirurgii uskorennogo vyzdorovleniia» [The principles of "accelerated surgery recovery"]. Zdravookhranenie. 2014;(5):34-48.
  7. Nichitailo ME, Bulik II. Sovremennye aspekty endovideokhirurgicheskogo lecheniia slozhnykh i retsidivnikh pakhovykh gryzh [Modern aspects endovideosurgical treatment of complex and recurrent inguinal hernias]. Klin Khirurgiia. 2010;(3):10-16.
  8. Zhebrovskii VV. Khirurgiia gryzh zhivota [Surgery of abdominal hernias]. Moscow, RF: Med Inform Agentstvo; 2005. 384 p.
  9. Tam KW, Liang HH, Chai CY. Outcomes of staple fixation of mesh versus nonfixation in laparoscopic total extraperitoneal inguinal repair: a meta-analysis of randomized controlled trials. World J Surg. 2010 Dec;34(12):3065-74. doi: 10.1007/s00268-010-0760-5.
  10. Petri A, Sebin K, red. Nagliadnaia statistika v meditsine [Visual statistics in medicine]. Leonov VP, per. s angl. Moscow, RF: GEOTAR-MED; 2003. 144 p.
  11. Palamarchuk VI, Shuliarenko VA, Siriachenko VG, Ignatov IN, Shuliarenko OV. Sposob total'noi ekstraperitoneal'noi gernioplastiki [A method of total extraperitoneal hernia repair]. Patent ¹102998 Ukraina. 25.11.2015.
  12. Lau H, Patil NG, Yuen WK, Lee F.Urinary retention following endoscopic totally extraperitoneal inguinal hernioplasty. Surg Endosc. 2002 Nov;16(11):1547-50.
  13. Bittner R, Schmedt CG, Leibl BJ. Transabdominal pre-peritoneal approach. In: LeBlanc KA. Laparoscopic hernia surgery. London, UK: Arnold Publisher; 2003. p. 54-64.
  14. Lau H, Loong F, Yuen WK, Patil NG. Management of herniated retroperitoneal adipose tissue during endoscopic extraperitoneal inguinal hernioplasty. Surg Endosc. 2007 Sep;21(9):1612-16.
  15. Nasr AO, Tormey S, Walsh TN. Lipoma of the cord and round ligament: an overlooked diagnosis? Hernia. 2005 Oct;9(3):245-47.
Address for correspondence:
04112, Ukraine, Kiev, Dorogozhytskaya st., 9, department of surgery and vascular surgery.
Tel: +380 444 32-24-52
E-mail: oleg.v.shu@gmail.com
Shulyarenko Oleg Vladimirovich
Information about the authors:
Shulyarenko O.V. PhD, Ass. Professor, of National Medical Academy of Post-graduate Education named after P.L. Shupyk, department of surgery and vascular surgery.
Contacts | ©Vitebsk State Medical University, 2007-2023