Authors
Chernykh V.G.
RUDN University, Moscow
Abstract
A method of allogernioplasty is proposed, which is a modification of the Lichtenstein operation, aimed at preserving the cremaster reflex in the postoperative period. The proposed method was used in 25 patients aged 23 to 50 years (the main group). Right–sided hernias were diagnosed in 14 cases (56%), left-sided hernias — in 11 (44%). The control group consisted of 25 patients, aged 29 to 48 years, operated according to the classic Lichtenstein method. Right–sided hernias were diagnosed in 16 cases (64%), left-sided hernias — in 9 (36%). Both groups corresponded to each other according to the age of the patients, the duration of herniation and the presence of concomitant diseases. Clinical efficacy was assessed by the preservation of the cremaster reflex in the postoperative period. In 1 (4%) patient of the control group, a hematoma of the postoperative wound was detected. The postoperative bed-day in both groups did not differ. After 1 week after surgery, in all patients of the main group, the testicle on the side of the intervention changed its position. A distinct cremaster reflex was detected in 12 (48%) patients, weakened in 13 (52%). In the control group, the weakened cremaster reflex was detected in 8 (32%) patients, it was not detected in 17 (68%). An year after the operation, the cremaster reflex was determined in all patients of the main group and only in 40% of patients of the control group (P<0.05). Partial restoration of the cremaster reflex on the side of the operation in the control group during the year occurred only in 8% of patients, and in 60% — the testicle lost the ability to change its position.
Keywords: oblique inguinal hernia, hernioplasty, cremaster reflex.
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