RESUMO
Own experience was presented of surgical treatment of 22 patients, suffering abdominal wall hernia, in whom processus vermiformis (PV) was revealed in a hernial sac during herniotomy performance. In such cases PV was macroscopically not changed or had various grades of change--from hyperemia, cicatricial thickening and involvement into adhesive process to its pronounced inflammation and destruction. Hernioplasty in conjunction with appendectomy was performed in 11 patients, in 10 of them--allohernioplasty, in 1--plasty, using tissues of their own. According to histologic investigations data the expediency of appendectomy performance in a planned order in patients while pathologic changes in PV present was confirmed. Late results of surgical treatment were studied up in 19 (86%) patients. Hernial recurrence was not observed.
Assuntos
Apêndice/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Hérnia Abdominal/cirurgia , Idoso , Idoso de 80 Anos ou mais , Apêndice/patologia , Feminino , Hérnia Abdominal/diagnóstico , Hérnia Abdominal/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
In 44 patients, ageing 39-73 yrs and suffering inguinal hernia recurrence, the investigation of musculo-aponeurotic structures of inguinal region was conducted. In 21 patients, suffering primary inguinal hernia recurrence, in concurrence with the connective tissue complex degeneration the pronounced atrophy of tissues was revealed. In 23 patients, suffering multiple inguinal hernia recurrence, the tissues degeneration and atrophy were manifested significantly. The results of investigation trust the necessity of additional plastic material application while performing hernioplasty for inguinal hernia recurrence. To optimize the primary inguinal hernia recurrence, the combined hernioplasty, applying polypropylene mesh, was performed, and for secondary recurrence--preperitoneal allohernioplasty, using operative access through the inguinal channel.
Assuntos
Hérnia Inguinal/prevenção & controle , Hérnia Inguinal/cirurgia , Canal Inguinal , Músculo Esquelético , Telas Cirúrgicas , Procedimentos Cirúrgicos Operatórios/métodos , Adulto , Idoso , Hérnia Inguinal/patologia , Humanos , Canal Inguinal/patologia , Canal Inguinal/cirurgia , Pessoa de Meia-Idade , Músculo Esquelético/patologia , Músculo Esquelético/cirurgia , Polipropilenos , Prevenção Secundária , Telas Cirúrgicas/estatística & dados numéricos , Resultado do TratamentoRESUMO
Immediate and late results of surgical treatment were analyzed in 365 patients aged from 30 to 80 years with inguinal hernia using net of polypropylene and the PHS system in comparison with results of autoplastic operations, performed in 326 patients. Application of net of polypropylene and the PHS system allows to improve in patients the surgical treatment result significantly because of reliable strengthening of inguinal canal fundus without tension of tissues. Early postoperative rehabilitation and the lowering of recurrences occurrence justify significant advantages of such hernioplasty over autoplastic methods and its wide application in surgical treatment of primary inguinal hernia.
