This journal is
indexed in Scopus
Year 2016 Vol. 24 No 5
GENERAL & SPECIAL SURGERY
S.V. SHALASHOV 1, L.K. KULIKOV 2, E.A. SEMENISHCHEVA1, I.A. EGOROV 1, A.L. MIKHAYLOV 1, E.M. YURKIN 1
A COMPARATIVE ANALYSIS OF RESULTS OF I.L. LICHTENSHTEIN TECHNIQUE AND CS-INGUINAL HERNIAPLASTY
NME "Railways Clinical Hospital on the station Irkutsk-Passazhirsky" of JSC "Russian Railways"1,
SBEE APE "Irkutsk State Medical Academy of Post-graduate Education"2,
The Russian Federation
Objectives. To conduct the comparative analysis of the results of I.L. Lichtenshtein and CS-inguinal herniaplasty.
Methods. 172 patients were enrolled into the study. 88 patients underwent I.L.Lichtenstein inguinal hernia repair and were included in the clinical comparison group (CCG). 84 patients were operated on using the proposed «combined seam» (CS-plasty) technique and composed the basic group (BG).
Results. When performing hernia repair by I.L. Lichtenstein (CCG), the duration of surgery was 50,2±13,2 min. CS-plasty lasted for 40,3 (±12,1) minutes in BG. The early incisional period was without complications both in BG and in CCG. Treatment results were followed for 84 BG patients and 85 CCG patients within the period from 12 months to 2 years. A lot more severe and long-lasting pain manifestations in early postoperative period in CCG in comparison with those in BG were registerted. Clinically significant pain syndroms occurred in nine cases in CCG at time of hospital discharge, in other words on 7th days after repair. There were no such pain manifestations in BG. Chronic pain was marked twice in CCG, no other complications were noted. Chronic pain lasted for up to 1 year and required anti-inflammatory therapy and physiotherapy. There were no delayed complications in BG. No recurrences occurred in both groups within the observed period.
Conclusion. CS-inguinal herniaplasty has many merits of existing «non-tension» methods. The presented plasty method is considered to be easy and allows eliminating inguinal hernia quickly and reliably. Pain manifestations are less marked in the operative zone after CS-inguinal herniaplasty in comparison with I.L. Lichtenstein technique and no cases of chronic pains were registered.
- Jenkins JT, O'Dwyer PJ. Inguinal hernias. BMJ. 2008 Feb 2;336(7638):269-72. doi: 10.1136/bmj.39450.428275.AD.
- Shliakhovskii IA, Chekmazov IA. Sovremennye aspekty khirurgicheskogo lecheniia gryzh briushnoi stenki [Modern aspects of surgical treatment of abdominal wall hernias]. Abdomin Khirurgiia. 2002;04(7):44-47.
- Köninger JS, Oster M, Butters M. Management of inguinal hernia – a comparison of current methods. Chirurg. 1998 Dec;69(12):1340-4. [Article in German]
- Timoshin AD, Iurasov AV, Shestakov AL. Khirurgicheskoe lechenie pakhovykh i posleoperatsionnykh gryzh briushnoi stenki [Surgical treatment of inguinal and postoperative abdominal wall hernias]. Moscow, RF: Triada-Kh, 2003. 144 p.
- Tabbara M, Genser L, Bossi M, Barat M, Polliand C, Carandina S, et al. Inguinal hernia repair using self-adhering sutureless mesh: Adhesix™: a 3-year follow-up with low chronic pain and recurrence rate. Am Surg. 2016 Feb;82(2):112-16.
- Hallén M, Sandblom G, Nordin P, Gunnarsson U, Kvist U, Westerdahl J. Male infertility after mesh hernia repair: a prospective study. Surgery. 2011 Feb;149(2):179-84. doi: 10.1016/j.surg.2010.04.027.
- Bendavid R. Dysejaculation. Hernia. 2009;(1):24.
- Fitzgibbons RJ. Can we be sure polypropylene mesh causes infertility? Ann Surg. 2005 Apr;241(4):559-61. doi: 10.1097/01.sla.0000157210.80440.b7PMCID: PMC1357058.
- Chernousov A, Khorobrykh T, Siniakin S, Vychuzhanin D, Belousov A. Khronicheskaia posleoperatsionnaia pakhovaia bol' [Chronic postoperative groin pain]. Vrach. 2015;(7):34-37.
- Nienhuijs S, Staal E, Strobbe L, Rosman C, Groenewoud H, Bleichrodt R. Chronic pain after mesh repair of inguinal hernia: a systematic review. Am J Surg. 2007 Sep;194(3):394-400.
- Sajid MS, Leaver C, Baig MK, Sains P. Systematic review and meta-analysis of the use of lightweight versus heavyweight mesh in open inguinal hernia repair. Br J Surg. 2012 Jan;99(1):29-37. doi: 10.1002/bjs.7718.
- Koch CA, Greenlee SM, Larson DR, Harrington JR, Farley DR. Randomized prospective study of totally extraperitoneal inguinal hernia repair: fixation versus no fixation of mesh. JSLS. 2006 Oct-Dec;10(4):457-60.
- Petri A, Sebin K. Nagliadnaia statistika v meditsine. Leonova VP, per. s angl. Moscow, RF: GEOTAR-MED; 2003. 144 p.
- Nyhus LM. Classification of groin hernia: milestones. Hernia. 2004 May;8(2):87-8.
- Shalashov SV, Kulikov LK, red. Pakhovye gryzhi u vzroslykh [Inguinal hernias in adults]: ruk dlia vrachei. Novosibirsk, RF: Nauka; 2011. 136 p.
- Shalashov SV, Egorov IA, Zakharov AG, Mikhailov AL, Iurkin EM. Sposob plastiki pri pakhovykh gryzhakh [A method of inguinal hernias plastics]. Patent ¹2371106 Ros Federatsii. 27.10.2009.
- Kharchenko IuA. Adekvatnaia otsenka boli – zalog ee uspeshnogo lecheniia [Adequate assessment of pain - the key to its successful treatment]. Universum: Meditsina i Farmakologiia [Elektronnyi resurs]. 2014 [data dostupa: 2016 iiun' 26];(4). Rezhim dostupa: http://7universum.com/ru/med/archive/item/1229.
- Kalantarov TK, Vakulin GV, Melkanian AG, Begun MS. Vozmozhnosti «svobodnoi ot natiazheniia» plastiki briushnoi stenki pri ustranenii pakhovoi gryzhi [Features of "tension-free" plastic abdominal wall while eliminating inguinal hernia]. Vestn Nats Med-Khirurg Tsentra im NI Pirogova. 2011;6(3):38-40.
664013, Russian Federation,
Irkutsk, Obraztsov st., 27,
Road Clinical Hospital Art.
Irkutsk-Passenger JSC Russian Railways, department of surgical diseases.
Tel: +7 (950) 069 35 67
Shalashov Sergey Vladimirovich
Shalashov S.V. PhD, Surgeon of department of surgical diseases, NME "Railways Clinical Hospital on the station Irkutsk-Passazhirsky" of JSC "Russian Railways".
Kulikov L.K. MD, Professor of department of surgical diseases, SBEE APE "Irkutsk State Medical Academy of Post-graduate Education".
Semenishcheva E.A. PhD, Chief Physician, NME "Railways Clinical Hospital on the station Irkutsk-Passazhirsky” of JSC "Russian Railways".
Egorov I.A. Head of department of surgical diseases, NME "Railways Clinical Hospital on the station Irkutsk-Passazhirsky" of JSC "Russian Railways",
Mikhaylov A.L. Surgeon of surgical department., NME "Railways Clinical Hospital on the station Irkutsk-Passazhirsky" of JSC "Russian Railways".
Yurkin E.M. Surgeon of department of surgical diseases, NME “Railways Clinical Hospital on the station Irkutsk-Passazhirsky” of JSC “Russian Railways”.