Immediate and late follow-up results of auto- and alloplastic operations in inguinal hernias

Keywords: inguinal hernia; autohernioplasty; allohernioplasty; laparoscopic hernuoplasty.

Abstract

Objective. To conduct a scientific investigation for comparative investigation of results of auto- and allohernioplastic operations.

Materials and methods. The investigation was based on analysis of postoperative results in 400 patients, ageing 16 - 85 yrs old, to whom in Scientific Surgical Centre named after Acad. M. A. Topchibashev and the City of Shirvan Central Hospital in 2009-2019 yrs period surgical treatment for inguinal hernia was conducted. Depending on the procedure of hernioplasty applied, the patients were divided into two Groups. In a control one (n=200) the operations were performed, using open autohernioplasty only. In the main Group (n=200) open procedure and laparoscopic allohernioplasty, using different synthetic nets, were applied.

Results. Comparative analysis of intraoperative, postoperative immediate and late follow-up results in the patients after auto- and allohernioplasty was done. In accordance to criteria of the intraoperative and immediate postoperative morbidity rate the statistically meaningful differences between two groups of patients were absent. Good late results of allohernioplasty were noted in (71.8 ± 3.41)%, satisfactory - in (17.2 ± 2.86)%, poor - in (11 ± 2.36)% patients (p<0.05); allohernioplasties - accordingly, in (80.2 ± 2.91)%, (16 ± 2.68)% and (3.8 ± 1.39)% patients (p<0.05). Comparative analysis done have shown the statistically much better results of allohernioplasty. Recurrences after allohernioplasty were observed in 3 times less frequently - 3.8%, and after autohernioplasty this index have constituted 11% (p < 0.05). Сomparative analysis of late follow-up results of various autohernioplastic methods have shown good results of Postemskyi method in (76.7 ± 7.72)% patients, and of Postempskyi method in our modification - in (88.9 ± 7.41)% patients. Good results of autoplasty in other methods were noted merely in equal quantity of the patients - in up to 70%, and statistically significant difference was absent.

Conclusion. Basing on own results obtained, we recommend to perform autohernioplasty of the inguinal channel anterior wall in accordance to Girard-Sposokukotskyi method with Kimbarovskyi suture for oblique inguinal hernias, while in direct inguinal hernias, for strengthening of posterior wall, - Postempskyi method in our modification. In large and recurrent hernias in patients of middle and senile age it is expedient to apply a Lichtenstein plasty in our modification. Total extraperitoneal or transabdominal preperitoneal plasty is recommended if technical installments needed and the physician’n laparoscopic skills are available.

Author Biographies

Z. T. Shirinov, Scientific Surgical Centre named after Acad. M. A. Topchibashev, Baku, Azerbaijani Republic

Shirinov Zarraf Tahmaz oglu - MD, DSci(Med)
Chief Researcher of the department of Surgery of the Liver, Gallbladder and Pancreas,
Scientific Center of Surgery named after M.A. Topchubashev.
AZ 1122. Baku, St. Sharifzade, 196. Republic of Azerbaijan.
dr.zerraf.shirinov@gmail.com
(99412) 4321830;
+994 50 354 21 51.
https://orcid.org/0000-0002-8438-9230

E. A. Alieva, Scientific Surgical Centre named after Acad. M. A. Topchibashev, Baku, Azerbaijani Republic

Alieva Elmira Agaali qizi - MD, DSci(Med),
Chief Researcher of the department of Surgery of the Liver, Gallbladder and Pancreas
Scientific Center of Surgery named after M.A. Topchubashev.
AZ 1122. Baku, St. Sharifzade, 196. Republic of Azerbaijan.
agaali.aliev@mail.ru
(99412) 4321830;
+994 50 345 93 95.
orcid.org/0000-0002- 7626-9490

Z. N. Azadova, Scientific Surgical Centre named after Acad. M. A. Topchibashev, Baku, Azerbaijani Republic

Azadova Zohra Novruz qizi - MD, junior researcher
Department of Surgery of the Liver, Gallbladder and Pancreas
Scientific Center of Surgery named after M.A. Topchubashev.
AZ 1122. Baku, St. Sharifzade, 196. Republic of Azerbaijan.
zohraazadova01@gmail.com
(99412) 4321830;
+994 55 857 54 84.
http://orcid.org/0000-0002-7002-3895.

N. Kh. Khankishiev, Central Hospital, City of Shirvan, Azerbaijani Republic

Khankishiev Namizad Hanfa oglu - MD, PhD(Med).
Chef of the surgical department
Central Hospital
AZ 1800. Heydar Aliyev Avenue, Shirvan, Republic of Azerbaijan.
namized.khankishiyev@gmail.com
(99421) 215 03 61;
+99450 353 90 52.
https://orcid.org/0000-0002-0983-2298

References

HerniaSurge Group. International guidelines for groin hernia management. Hernia. 2018 Feb;22(1):1-165. doi: 10.1007/s10029-017-1668-x. Epub 2018 Jan 12. PMID: 29330835; PMCID: PMC5809582.

Chen LS, Chen WC, Kang YN, Wu CC, Tsai LW, Liu MZ. Effects of transabdominal preperitoneal and totally extraperitoneal inguinal hernia repair: an update systematic review and meta-analysis of randomized controlled trials. Surg Endosc. 2019 Feb;33(2):418-28. doi: 10.1007/s00464-018-6314-x. Epub 2018 Jul 9. PMID: 29987564.

Miserez M, Peeters E, Aufenacker T, Bouillot JL, Campanelli G, Conze J, et al. Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2014 Apr;18(2):151-63. doi: 10.1007/s10029-014-1236-6. Epub 2014 Mar 20. Erratum in: Hernia. 2014 Jun;18(3):443-4. PMID: 24647885.

Somen Jha, Pankaj. A study to assess the prevalence and risk factors of inguinal hernia . Int J Surg Sci 2020;4(3):330-2. DOI: https://doi.org/10.33545/surgery.2020.v4.i3e.514

Murphy BL, Zhang J, Ubl DS, Habermann EB, Farley DR, Paley K. Surgical trends of groin hernia repairs performed for recurrence in medicare patients. Hernia. 2019 Aug;23(4):677-83. doi: 10.1007/s10029-018-1852-7. Epub 2018 Nov 9. PMID: 30414000.

Egiev VN, Liadov VK, Bogomazova SIu. Intraperitoneal ventral hernia plasty: the comparison of prosthetic materials. Khirurgiia (Mosk). 2010;(10):36-41. Russian. PMID: 21169928.

Stoppa RE, Rives JL, Warlaumont CR, Palot JP, Verhaeghe PJ, Delattre JF. The use of Dacron in the repair of hernias of the groin. Surg Clin North Am. 1984 Apr;64(2):269-85. doi: 10.1016/s0039-6109(16)43284-6. PMID: 6233733.

Lichtenstein IL. Herniorrhaphy. A personal experience with 6,321 cases. Am J Surg. 1987 Jun;153(6):553-9. doi: 10.1016/0002-9610(87)90153-x. PMID: 3296805.

Nyhus LM, Pollak R, Bombeck CT, Donahue PE. The preperitoneal approach and prosthetic buttress repair for recurrent hernia. The evolution of a technique. Ann Surg. 1988 Dec;208(6):733-7. doi: 10.1097/00000658-198812000-00010. PMID: 3196094; PMCID: PMC1493832.

Rosa JJ, Launois R. Comparative health systems. France. Adv Health Econ Health Serv Res Suppl. 1990;1:179-95. PMID: 10113790.

Published
2020-12-28
How to Cite
Shirinov, Z. T., Alieva, E. A., Azadova, Z. N., & Khankishiev, N. K. (2020). Immediate and late follow-up results of auto- and alloplastic operations in inguinal hernias. Klinicheskaia Khirurgiia, 87(11-12), 48-53. https://doi.org/10.26779/2522-1396.2020.11-12.48
Section
General Problems of Surgery