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The articles published under CC BY NC-ND license Цель. Улучшить результаты лечения пациентов с неосложненной бедренной грыжей путем выявления особенностей клинического течения заболевания и обоснованного применения способов операций с учетом возможного разрушения связки Купера. Материал и методы. Проведен анализ лечения 46 пациентов с неосложненной бедренной грыжей. Мужчин было 12 (26%), женщин-34 (74%). В контрольную группу вошли 24 пациента с пластикой грыжевых ворот местными тканями. В основную группу-22 пациента, у которых использовали протезирующую пластику, в том числе с использованием предложенного способа операции. Оценку результатов пластик бедренного канала в группах проводили по частоте развития осложнений. Результаты. В контрольной группе ранние осложнения возникли у 11 пациентов: гематома-у 3; воспалительная инфильтрация раны-у 4; нагноение раны-у 4. Поздние осложнения выявлены у 12 пациентов: боль в зоне операции-у 4; парастезии-у 5; ощущение дискомфорта в паховой области-у 3, рецидивы заболевания-у 4. В основной группе ранние осложнения возникли у 4 пациентов: гематома-у 1, воспалительная инфильтрация раны-у 1, нагноение раны-у 1, серома-у 1. Поздние осложнения выявлены у 3 пациентов: боль в зоне операции-у 1, онемение-у 1, ощущение дискомфорта в паховой области-у 1, рецидивы заболевания-у 2. Применение протезирующих способов пластики бедренного канала позволило снизить частоту ранних осложнений в 2,5 раза, поздних-в 3,7 раза, число рецидивов заболевания-в 2 раза. Заключение. Пластика бедренного канала местными тканями и с использованием протеза ограничена при разрушении связки Купера. Предлагаемый способ операции протезом с выступом по нижнему медиальному краю позволяет выполнить операцию при разрушении тканей в зоне бедренного канала. Ключевые слова: бедренная грыжа, протезы и имплантаты, диагностика, способы операций, результаты лечения Objective. To improve the treatment results of patients with uncomplicated femoral hernia by identifying the features of clinical course and reasonable application of the operation methods taking into account a possible destruction of the Cooper ligament. Methods. The treatment analysis of 46 patients with uncomplicated femoral hernia was performed. There were 12 males (26%) and 34 females (74%). The control group included 24 patients with the repair of hernial orifice with local tissues. The main group included 22 patients in whom prosthetic repair has been used, including using the proposed method of operation. The results evaluation of the femoral canal repair in groups was performed according to the incidence of complications. Results. In the control group, early complications occurred in 11 patients: hematoma-in 3; inflammatory wound infiltration-in 4; suppuration of the wound-in 4. Late complications were found in 12 patients: pain in the surgical area-in 4; parasthesia-in 5; groin discomfort-in 3, recurrence of the disease was revealed in 4. In the main group, early complications occurred in 4 patients: hematoma-in 1, inflammatory wound infiltrationin 1, w...

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Objective. To substantiate the methods of surgical treatment in patients with postoperative ventral hernias and created intestinal fistulas based on the comparison of the outcomes of one-stage and two-stage operations. Methods. The analysis of patients (n=40) with postoperative ventral hernias and created intestinal fistulas imposed for therapeutic purposes or created as the treatment outcomes of uncreated fistulas has been performed. Jejunal fistulas were present in 7 patients (17.5%), ileal fistulas in 18 (45%), and colonic fistulas in 15 (37.5%) patients. The patients of group 1 (n=15, 37.5% ) underwent the two-stage operations. First, the fistula was closed with the access to the site of its location, and then after 3-6 months, the excision of hernia was performed. In patients of group 2 (n=25, 62.5%) fistula was simultaneously removed and hernia was excised. The «tension-free»techniquesinhernia orifice repair in those groups was performed. The outcomes were evaluated by the number of local and general complications in the period from 10 days to 6 months. Results. Wound complications after the first operation developed in 2 (13.3%) patients in the 1^st group. There were no complications after the second stage of hernioplasty. In group 2, wound complications developed in 3 (12%) patients. There was no anastomotic failure in the groups. In the long terms, good results were obtained in 15 patients in group 1 and in 25 patients in group 2. The use of anterior prosthetic «tension-free»techniques of plastic surgery by the combined methods in one-stage allows obtaining results comparable to two-stage operations. Conclusion. In patients with hernias and intestinal fistulas, the method of treatment in one-stage or two-stages depends on the possibility of the gastrointestinal restoring patency from minimally invasive access in the site of the fistula location. What this paper adds For the first time, the indications for performing operations with postoperative ventral hernias and intestinal fistulas in one-stage and two-stage operations have been substantiated. Treatment option for patients with hernias and intestinal fistulas has been found to depend on the possibility of the gastrointestinal patency restoring from minimally invasive access in the site of the fistula location.

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