Сравнение тотальной экстраперитонеальной и трансабдоминальной преперитонеальной пластики паховой грыжи

Abstract

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) – 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. An average operation time – in the 1st group 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 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 hernioplasty is considered to be an operation of choice for groin hernias (2, 3A and 3B types) based on the Nyhus classification. Good early results were 34% higher in the total extraperitoneal inguinal herniaplasty group than in the transabdominal preperitoneal primary hernioplasty group.