RESUMO
Complex examination and surgical treatment was performed in 220 elderly and senile patients for various types of inguinal hernia (IH) in accordance to Nyhus classification. In 103 patients (the main group) hernioplasty was performed according to Lichtenstein method or using modifications, proposed by us; in 117 (the comparison group)--the tension hernioplasty, using the patient's tissues. According to data of morphological investigation of the inguinal channel musculo-aponeurotic structures in 24 patients there was established, that in the oblique IH formation a biochemical instability of the connective tissue structures plays a leading role, while in a direct type of IH--the reduction of muscular fibrils quantity, lowering their elasticity and a contractile answer velocity. Application of a tension-free methods of plasty in elderly and senile patients is pathogenetically substantiated, it permits to reduce the hospital stay, the physical rehabilitation duration, the complications and recurrences rate, and to improve quality of life in remote follow-up period after operative intervention.
