Year 2015 Vol. 23 No 6

GENERAL & SPECIAL SURGERY

A.V. CHERNYH, E.I. ZAKURDAEV, E.F. CHEREDNIKOV

ON THE POSSIBILITY OF DETERMINING MESH PROSTHESIS SIZE OF THE PREOPERATIVE INGUINAL HERNIA REPAIR

SBEE HPE "Voronezh State Medical University named after N.N. Burdenko",
The Russian Federation

Objectives. To develop the regression equations to predict the linear dimensions of an inguinal gap according anthropometric parameters of the anterior abdominal wall.
Methods. In the topographic and anatomic study the anthropometric parameters of anterior abdominal wall (the interspinal line, length of inguinal ligament, hypogastrium height) and the linear dimensions of inguinal gap (height, length) were studied on cadavers (n=123). Prior hernia repair the linear sizes of an inguinal gap with the use of the regression equations and within an operative intervention in 30 patients with inguinal hernias were determined during the clinical trials.
Results. In anatomic study it was established that the interosseus line made up 27,20,3 cm, the length of inguinal ligament 14,20,2 cm, the height of hypogastric area 7,70,15 cm, the height of inguinal gap 1,60,4 cm and the length 5,30,8 cm. Using correlation analysis a strong reliable correlation between the height of the inguinal gap, interosseus line (r=-0,7; p<0,01) and a height of hypogastric region (r=0,8; p<0,01) was determined. In turn, between the height of inguinal gap and the length of inguinal ligament as well as between the length of inguinal gap and the length of inguinal ligament an average reliable correlation r =-0,5 (p<0,05) was been registered.
On the basis of the obtained data the regression equations of forecasting of the linear dimensions of inguinal gap using anthropometric parameters of anterior abdominal wall were suggested: a=1,98+0,06×x1-0,14×x2+0,15×x3, b=7,91-0,18×x2 (a a height of inguinal gap, b a length of inguinal gap, x1 a the interspinal line, x2 a length of inguinal ligament, x3 height of hypogastric area). In a clinical study it was established the absence of statistically significant differences between the linear dimensions of the inguinal gap obtained before the hernia repair using proposed regression equations and measured during an operative intervention (p=0,82).
Conclusion. The proposed regression equations allow predicting the linear dimensions of the inguinal gap using anthropometric parameters of the anterior abdominal wall and can be useful in choosing the optimal size of the mesh prosthesis at the preoperative stage of inguinal hernia repair.

Keywords: inguinal hernia, mesh hernia repair, chronic groin pain, linear dimensions, inguinal gap, regression equations, operative intervention
p. 619-623 of the original issue
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Address for correspondence:
394036, Russian Federation,
Voronezh, ul. Studencheskaya, d. 10,
GBOU VPO "Voronezhskiy gosudarstvennyiy
meditsinskiy universitet
imeni N.N. Burdenko",
kafedra operativnoy khirurgii s
topograficheskoy anatomiey,
tel.: 7 (951) 566-43-61,
e-mail: ezakurdaev@rambler.ru,
Zakurdaev Evgeniy Ivanovich
Information about the authors:
Chernyh A.V. MD, professor, First Vice-Rector, a head of the operative surgery chair with topographic anatomy of SBEE HPE "Voronezh State Medical University named after N.N. Burdenko".
Zakurdaev E.I. PhD, an assistant of the operative surgery chair with topographic anatomy of SBEE HPE "Voronezh State Medical University named after N.N. Burdenko".
Cherednikov E.F. MD, professor, a head of the faculty surgery of SBEE HPE "Voronezh State Medical University named after N.N. Burdenko".
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