Hernia surgery - results
The quality of the surgical treatment of hernia measured operating time, complication rate, time to recovery of normal physical activity and price.
Arthur I Gilbert
From the literature review early complications in surgery or testes ranged up to 10-11%, with no significant differences with regard to the applied surgical technique.
In Medina the most important factors in the occurrence of wound complications after hernia surgery are: individual work of the surgeon, and the duration of obesity surgery hernia.
Like recurrence data in personal and aggregated data for research in recent complications are significantly higher. Hair is so scrutinized the majority of hernia operated on in Scotland and found a wound complications in 10%. Graupeot 1400 hernia operations established (10%) early complications. Alexander in 142 recurrent hernia operations reported 10% early complications.
Recurrences after hernia surgery
The results of a series of relatively large number of patients are presented in Table 1. There was a significant difference in the results of the individual authors and hernia centers and obshtohirurgichnata practice.
Таблица 1. Рецидиви
Hagan & Rhoads(1953)
Дирeдиректна херния 5%Индиректна херния 4%Рецидивна херния 21%
|Halverson & McVay (1970)||1211||
Palumbo & Sharpe(1971)
Първична херния 0,1%Рецидивна херния 2%
|Kark (1998)||3175||Lichtenstein||Първична херния 0.5%|
Първична херния 8,9%
Рецидивна херния 22%
|Vo Huu Le (2001)||236||Лапароскопски||15%|
Първична херния - 2,6%Рецидивна херния - 6,9%
In literature the reasons for recurrence are:
1) Inadequacy of primary hernia surgery:
a) wrong choice of surgical technique to restore the hernia defect;
b) poor technical performance: inadequate anesthesia inadequate access, inadequate dissection and reduction of hernia jackets including plazgashta hernia, hernia as a missed femoral hernia with inguinal hernia; insufficient and inadequate dissection repair muskulnoaponevrotichen the deep layer of the abdominal wall, allowing tension sewing line in hernia surgery without canvas; unsuitable suture hernia plastic, tissue trauma from rough handling;
2) Individual anatomofiziologichni and pathological conditions:
variations in the anatomy and physiology of the groin, behind the more unprotected area, existing and / or acquired inferiority of the supporting tissues, duration of hernia and the degree of damage to the abdominal wall.
3) Postoperative complications: wound complications - hematoma, wound inflammation, common complications and conditions leading to increased abdominal pressure - cough, vomiting, inflamed gallbladder, urinary retention, ascites, etc..
"If you learn false hernia surgery and continue to use their technique without worrying about results, significant improvement can be expected, just because you get older and" experienced "- writes Haapaniemi, substantiating his thesis and advantages created "Swedish Hernia Register" in 1992 to monitor and improve patient treatment.