EUROMEDICA  Hanover 23-24  Mai 2011	Advanced methods of diagnosis, treatment and prophylactics
	European Academy of Natural Sciences, Hanover European Scientific Society, Hanover

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Research objective: improvement of results of treatment of patients with recurrent inguinal hernias at the expense of optimization of a choice of a technique of operation.

Materials and methods: in work classification of recurrent hernias on G.Campanelli, 2006 et al is used.

In research, according to used classification, 173 patients with recurrent inguinal hernias have been included.

At all patients term of supervision after reconstructive operation exceeded two years.

The algorithm of preoperative inspection has been standardized and included obligatory carrying out of ultrasonic of a zone before the executed operative intervention.

Patients have been divided on two groups which authentically aren’t differing to compared signs.

The first group included 84 patients with recurrent inguinal hernias. From them 57 patients had type of relapse R3, 11 patients type of relapse R1 and 16 patients with relapse type R2.

From the second group (89 patients), 54 patients had R3 relapse type, 13 patients R1 type of relapse and 22 patients R2 relapse type.

All patients in the first group were it is executed reconstructive hernioplasty on Liechtenstein. In the second group to patients with relapse of an inguinal hernia of type R3 it was carried out reconstructive hernioplasty on Liechtenstein (54 patients), patients with type of relapse R1 and R2 (35 patients) - reconstructive nernioplasty with use synthetic implant an original construction from miniaccess to the defect aponevroza revealed at ultrasonic.

Comparative estimation of efficiency of surgical treatment spent by quantity of complications in the early and remote postoperative period. Among the nearest postoperative complications allocated the following: 1. Infiltrate p/о wounds; 2. A suppuration p/о wounds; 3. Seroma; 4. A hematoma p/о wounds; 5. A sharp delay of urine; 6. A scrotum hypostasis, testicle; 7. Ischemic orchitis; 8. The Vein thrombosis of the bottom extremities;

Complications have arisen at 19 (22,6 %) patients of the first group and at 12 (13,5 %) patients in the second group.

The remote complications - relapse of disease within two years after reconstructive operation in the first group is revealed at 3 (3,6 %) patients, in the second group relapse of an inguinal hernia is revealed at 2 (2,2 %) patients.

Conclusions:

1. Ultrasonic diagnostics is defining criterion in a choice of a technique of operation.
2. The differentiated approach to surgical treatment of recurrent hernias allows to reduce quantity of the early and remote postoperative complications.
3. Original method hernioplasty is effective in preventing development of inguinal hernia recurrence.