Surgical cure of inguinal hernias by the Lichtenstein procedure

Abstract

Introduction: The surgical treatment of the inguinal hernias is a current problem in terms of both frequency and the socio-economic complications involved. The actively employed people and the elderly are most frequently subjected to the surgical cures for inguinal hernias, which imposes the need to address the problem of reducing the period of hospital treatment, improve the quality of life, for the rapid socio-professional reintegration of the patient and the relapse prevention. The study aims at analyzing the results of the surgical treatment of inguinal hernias by the Lichtenstein procedure, highlighting the peculiarities of the surgical act and the advantages of using synthetic mesh during the treatment. Materials and methods: The study is based on the analysis of the treatment of 468 patients with a diagnosis of inguinal hernia treated in the Surgery clinic of the Chisinau NCSUMP in 2011-2012. The study group was divided as following, women - 38 (8,12%), while men - 430 (91,88%) (p<0,05). The average age was 53,5±0.79 years. There were 271 (57,9%) patients of the working age (60 years) and 197 over 60 years - 197 (42,1%). The Lichtenstein procedure was chosen for 321 (68,6%) of the total amount of the 454 operated cases. The repair was performed with the Pro-Meshand Biosintex meshes, having the 7x15 cm size, while the sutures - with a 2.0 polypropylene thread. Results: The postoperative period was favourable for most patients. By Clavien, postoperative complications occurred only in 2 patients, as determined by the simultaneous pathologies. The local complications (abscess, seroma, haematoma) were not reported in any patient. The average postoperative duration was 5,34±0,06 days, with the per prima regeneration of the postoperative wound in 100% cases. The patient's follow-up period was up to 12 months. Conclusions: The Lichtenstein procedure is the method of choice in the surgical cure of inguinal hernia due to the simplicity, efficiency, minimal postoperative pain and rapid socioeconomic reintegration of the patients. The cancellation of the blood pressure in the tissues allows to minimize the risk of relapse, providing greater comfort for the patient.