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Khirurgii

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Year 2017 Vol. 25 No 1

GENERAL & SPECIAL SURGERY

A.V. CHERNYH, E.I. ZAKURDAEV, E.F. CHEREDNIKOV, N.V. YAKUSHEVA, V.G. VITCHINKIN, M.P. ZAKURDAEVA, Y.V. MALEEV

A METHOD FOR PREVENTING OF INTRAOPERATIVE INTERCOSTAL NERVE TRAUMATIZATION AT HERNIOTOMY OF UMBILICAL HERNIAS

FSBEE HE "Voronezh State Medical University Named After N.N. Burdenko",
Voronezh,
The Russian Federation

Objectives. To develop a method of prognostication of the number of intercostal nerves in the lateral edge of the aponeurotic sheath of the rectus abdominis muscle in the umbilical region of the anterior abdominal wall.
Methods. The unfixed corpses (n= 88) of both sexes without pathology of the anterior abdominal wall were studied: 45% of male corpses (average age – 53,8±11,9 years) and 55% – females (51,9±13,2 years). Linea bicostalis (the distance between the lower points of the costal arches) and linea bispinalis (the distance between the front upper iliac spines) were measured. The number of the intercostal nerves at the lateral edge of the aponeurotic sheath of rectus abdominis muscle in the umbilical region of the anterior abdominal wall was established.
Results. Linea bicostalis on the average composed 29,2±0,3 cm and the linea bispinalis - 28,2±0,2 cm. In the area of the lateral edge of the aponeurotic sheath of rectus abdominis muscle in the umbilical region of the anterior abdominal wall, 2 pairs of the intercostal nerves were more often observed (60% of cases), rarely – 1 pair of nerves (20%). In 11% of cases there were 3 pairs of intercostal nerves to the rectus abdominis muscle, and 4 pairs of nerves in 2% of cases. In 7% of cases the asymmetric number of the intercostal nerves was registered. Using the logistic regression technique, the method was proposed predicting the probability of finding 2 pairs of intercostal nerves in the area of the lateral edge of the aponeurotic sheath of rectus abdominis muscle in the umbilical region at anterior abdominal wall: P=100×(1/(1+e^(12,1+0,33×a1-0,76×a2))), where P is the probability of finding 2 pairs of intercostal nerves, a1 – linea bispinalis, a2– linea bicostalis.
Conclusion. The developed method allows predicting the quantity of the intercostal nerves in the area of the lateral edge of the aponeurotic sheath of the rectus abdominis muscle in the umbilical region of the anterior abdominal wall and can be recommended for use in clinical practice.

Keywords: anterior abdominal wall, aponeurotic sheath, rectus abdominis muscle, innervation, intercostal nerves, umbilical hernia, hernia repair
p. 20-25 of the original issue
References
  1. Parshikov VV, Khodak VA, Petrov VV, Dvornikov AV, Mironov AA, Samsonov AA, Romanov RV. Retromuskuliarnaia plastika briushnoi stenki setkoi [Retromuscular plasty of abdominal wall by mesh]. Fund Issledovaniia. 2012;(7):159-163.
  2. Gutarra F. Dicled myofascial oblique rectus abdominis flap technique F. Gutarra, J.R. Asensio. Plast. Reconstr. Aesthet. Surg. 2009;(62):1490-1496.
  3. Moore M, Bax T, MacFarlane M, McNevin MS. Outcomes of the fascial component separation technique with synthetic mesh reinforcement for repair of complex ventral incisional hernias in the morbidly obese. Am J Surg. 2008 May;195(5):575-9; discussion 579. doi: 10.1016/j.amjsurg.2008.01.010.
  4. Mori H, Akita K, Hata Y. Anatomical study of innervated transverse rectus abdominis musculocutaneous and deep inferior epigastric perforator flaps Surg Radiol Anat. 2007 Mar;29(2):149-54.
  5. Skipidarpikov AA, Bezhin AI, Netiaga AA, Skipidarnikova AN. Osobennosti innervatsii priamykh myshts zhivota u liudei s razlichnymi tipami teloslozheniia [Features of the innervation of the rectus muscle in people with different body types]. Kursk Nauchno-Prakt Vestn Chelovek i Ego Zdorov'e. 2013;(1):21-26.
  6. Jkiz Z.A., üçerler Hülya. Bilateral absence of the tendinous intersection of the rectus abdominis muscle. Anatomy.2009:(3): 69-71.
  7. Meenakshi S, Manjunath K. Y. The tendinous intersection of rectus abdomines muscle J MGIMS, March 2008, Vol 13, No (1), 34 - 39
  8. M Haque, A Gupta, A Nasar. Variation in Tendinous Intersections of Rectus Abdominis Muscle in North Indian Population with Clinical Implications. J Clin Diagn Res. 2015 Jun; 9(6): AC10–AC12. Published online 2015 Jun 1. doi: 10.7860/JCDR/2015/14027.6028 PMCID: PMC4525496
  9. Suh HS, Eom JS, Lee TJ. Anatomical Location of the Tendinous Intersections of the Rectus Abdominis Muscle in Korean Women. J Korean Soc Plast Reconstr Surg. 2006 Jul 33(4):469-473.
  10. Maleev IuV, Chernykh AV, Shevtsov A N, Golovanov DN, Stekol'nikov V V. Aktual'nye voprosy tipovoi anatomii perednei oblasti shei v aspekte zaprosov klinicheskoi praktiki [Topical issues of the typical anterior of the neck anatomy in the aspect of clinical practice inquiries]. Zhurn Anatom i Gistopatol. 2015;4(3):79-80
  11. Sushkou SA, Korobov GD, Miadelets OD. Metod vyiavleniia atrofii stenki zadnikh bol'shebertsovykh ven pri varikoznoi bolezni [Method for detection of atrophy of the wall of the posterior tibial veins in varicosity]. Novosti Khirurgii. 2013;21(3): 90-102.
  12. Red'kin AN, Banov SM, Popov SS, Novomlinskaia NI, Ostroushko AP, Sokolov AP, Sokolova MG, Glukhov AA. Novyi metod dooperatsionnogo prognoza effektivnosti limfodissektsii u bol'nykh rakom molochnoi zhelezy [A new method of preoperative prediction efficiency of l lymphodissection in patients with breast cancer] Vestn Eksperim i Klin Khirurgii. 2015;(8):1:100-110
  13. Sudakov DV, Korovin EN, Rodionov OV, Sudakov OV, Fursova EA. Vybor taktiki lecheniia oslozhnenii sakharnogo diabeta na osnove neirosetevogo modelirovaniia [Choice of treatment tactics of diabetes complications based on neural network modeling]. Sistemnyi Analiz i Upravlenie v Biomed Sistemakh. 2014;13(3):592-597.
  14. Chernykh AV, Zakurdaev EI, Zakurdaeva MP. K voprosu o profilaktike travmatizatsii mezhrebernykh nervov pri zadnei separatsionnoi gernioplastike pupochnykh gryzh [The issue of prevention of traumatic intercostal nerves at the posterior separation umbilical hernia repair]. Novosti Khirurgii. 2016;24(3):234-239. doi: 10.18484/2305-0047.2016.3.234
Address for correspondence:
394036, the Russian Federation, Voronezh,
Student str., 10,
FGBOU HE «Voronezh State
Medical University named after NN Burdenko»,
Department of operative surgery and
topographic anatomy.
Tel.: 8 951 566-43-61
E-mail: ezakurdaev@rambler.ru
Evgeny I. Zakurdaev
Information about the authors:
Chernyh A.V. MD, Professor, Head of the operative surgery department with topographic anatomy, FSBEE HE "Voronezh State Medical University Named After N.N. Burdenko".
Zakudaev E.I. PhD, Assistant of the operative surgery department with topographic anatomy, FSBEE HE "Voronezh State Medical University Named After N.N. Burdenko".
Cherednikov E.F. MD, Professor, Head of the faculty surgery department, FSBEE HE "Voronezh State Medical University Named After N.N. Burdenko".
Yakusheva N.V. PhD, Ass. Professor of the operative surgery departmentr with topographic anatomy, FSBEE HE "Voronezh State Medical University Named After N.N. Burdenko".
Vitchinkin V.G. PhD, Ass. Professor of the operative surgery department with topographic anatomy, FSBEE HE "Voronezh State Medical University Named After N.N. Burdenko".
Zakudaeva M.P. Post-graduate student of the operative surgery departmentr with topographic anatomy, FSBEE HE "Voronezh State Medical University Named After N.N. Burdenko".
Maleev Y.V. MD, Ass. Professor of the operative surgery department with topographic anatomy, FSBEE HE "Voronezh State Medical University Named After N.N. Burdenko".
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