Pathohistological Prereconditions for Development of Complications and R Ecurrences I N Inguinal Hernioplasty

Abstract

Summary. Inguinal hernioplasty is the most frequently performed surgical operation in the world, but the level of complications still reaches 11 % and of recurrences — 5 %. According to some authors, the reason may be in chronic inflammatory changes of the hernia sac and perihernial tissues.
 Aim. To study the pathohistological changes of the hernia sac and perihernial tissues of patients with inguinal hernias for development of adequate methods of complications prophylactics.
 Material and methods. The pathohistological examination of fragments of hernial sac and perihernial tissues of 24 patients with groin hernias was performed.
 Results and discussion. The investigation detected the signs of chronic inflammation in fragments of tissue of hernial sac in all patients. In 8 (33,3 %) patients the signs of inflammation were found only in fragments of hernial sac, and in 16 (66,7 %) – they were combined with the inflammation of perihernial tissues. Among them, the pronounced signs of chronic inflammation were found in 6 (25,0 %) patients with recurrent groin hernias, they were combined with the pronounced scarring changes of hernial sac and perihernial tissues.
 Conclusions. 1. Chronic inflammatory changes of the hernia sac and perihernial tissues are among the reasons for the development of postoperative complications and recurrences. 2. An important component of prevention of complications can be use of antibacterial and anti-inflammatory drugs.