Novosti
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This journal is indexed in Scopus |
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Year 2015 Vol. 23 No 1
GENERAL AND SPECIAL SURGERY
A.V. CHERNYH, E.I. ZAKURDAEV, E.N. LYUBYH, V.G. VITCHINKIN
WAVELIKE RELAXING INCISION OF THE ANTERIOR RECTUS SHEATH MEDIATED PLASTIC REPAIR OF THE INGUINAL CANAL
SBEE HPE " Voronezh State Medical Academy named after N.N. Burdenko",
The Russian Federation
Objectives. To develop and to evaluate wavelike relaxing incision of the anterior rectus sheath in experiment and clinical practice.
Methods. Muscle tension was measured with spring dynamometer prior and after the relaxing incision performance in experiment on 24 cadavers. A randomized clinical trial has been carried out on 60 patients with the unilateral uncomplicated inguinal hernias. The patients were divided into three groups depending on the performed inguinal hernia repair. The mediated plasty with a wavelike relaxing incision has been applied in the main group. The mediated plasty according to the classical method was performed to the patients in the first control group. The Lichtenstein tension-free hernioplasty was carried out in the second control group.
Results. The tension of the ligature in the medial corner of the inguinal gap needed for conjunction of lower layers of abdominal lateral muscles with inguinal ligament mediated plasty prior relaxing incision was 27,2±0,4 T, and after relaxing incision performance – 15,8±0,3 T. There were no any recurrence of the inguinal hernias in each studied group within 2-years period. Early postoperative complications developed in 15% of patients of the 1st control group (5% – the scrotal swelling, 10% – paresis of the bladder) and 5% of patients of the second control group – serous inflammation. Chronic pain syndrome was observed in 20% of the second control group patients.
Conclusion. The results of experimental and clinical studies have shown the performance of the wavelike relaxing incision of anterior wall of the rectus sheath mediated plastic repair of the inguinal canal substantially reduces the risk of postoperative complications and recurrence.
- Vizgalov SA, Smotrin SM. Kombinirovannaia atenzionnaia gernioplastika pri naruzhnykh pakhovykh gryzhakh [Combined attentional hernioplasty with external inguinal hernias]. Novosti Khirurgii. 2012;20(3):9-15.
- Koshelev PI. Innovatsionnye puti sovershenstvovaniia metoda nenatiazhnoi gernioplastiki [Innovative ways of improving the method of non-tension hernioplastics]. Sistem Analiz i Upravlenie v Biomed Sistemakh. 2007;6(2):528-32.
- Ostrovskii VK. Sposob dvukhsloinoi plastiki zadnei stenki pakhovogo kanala pri pakhovykh gryzhakh Khirurgiia [A method of two-layer plastic of the back wall of the inguinal canal with inguinal hernias]. Khirurgia. Zhurn im NI Pirogova. 2009;(3):67-68.
- Chernykh AV, Liubykh EN, Vitchinkin VG, Zakurdaev EI. Anatomicheskoe obosnovanie modifikatsii oposredovannoi plastiki pakhovogo kanala [Anatomic substantiation of mediated plasticity modification of the inguinal canal]. Novosti Khirurgii. 2014;22 (4):403-407.
- Desarda MP.New method of inguinal hernia repair: a new solution. ANZ J Surg. 2001 Apr;71(4):241-44
- Figueiredo CM, Lima SO, Xavier Júnior SD, da Silva CB.Morphometric analysis of inguinal canals and rings of human fetus and adult corpses and its relation with inguinal hernias. [Article in Portuguese] Rev Col Bras Cir. 2009 Aug;36(4):347-49.
- Read RC. Herniology: past, present, and future. Hernia. 2009 Dec;13(6):577-80.
- Ioffe IL. Operativnoe lechenie pvkhovykh gryzh [Surgical treatment of inguinal hernias]. Moscow, USSR: Meditsina. 1968. 172 p.
394036, Rossiyskaya Federatsiya,
g. Voronezh, ul. Studencheskaya, d. 10,
GBOU VPO "Voronezhskaya gosudarstvennaya
meditsinskaya akademiya
imeni N.N. Burdenko", kafedra operativnoy khirurgii
s topograficheskoy anatomiey,
tel.: 7(951)566-43-61,
e-mail: ezakurdaev@rambler.ru,
Zakurdaev Evgeniy Ivanovich
Chernyh A.V. MD, professor, First Vice-rector, a head of the operative surgery chair with topographic anatomy of SBEE HPE "Voronezh State Medical Academy named after N.N. Burdenko".
Zakurdaev E.I. A post-graduate student of the operative surgery chair with topographic anatomy of SBEE HPE "Voronezh State Medical Academy named after N.N. Burdenko".
Lyubyh E.N. MD, professor, director of the Research Institute of gerontology, professor of the faculty surgery chair of SBEE HPE "Voronezh State Medical Academy named after N.N. Burdenko".
Vitchinkin V.G. PhD, associate professor of the operative surgery chair with topographic anatomy of SBEE HPE "Voronezh State Medical Academy named after N.N. Burdenko".