THE COMPARATIVE ANALYSIS OF THE RESULTS OF ULTRASOUND IMAGING AND MORPHOMETRIC EXAMINATION OF TOPOGRAPHIC AND ANATOMICAL PARAMETERS OF THE INGUINAL CANALIN ELDERLY PATIENTS WITH HERNIA

Objective: to assess the potential of using the results of ultrasound imaging of the inguinal channel in order to select an optimal method of hernioplasty for elderly patients. Material and methods . The work is based on the results of examination of 37 elderly patients with inguinal hernias of II, IIIа, and IIIb type according to L. Nyhus. Ultrasound imaging and intraoperative assessment of the topographic and anatomical parameters of the inguinal channel were performed. The height of the inguinal interval, cumulative thickness of the inner oblique and transverse abdominal muscles forming the overhead wall of the inguinal channel, and also the diameter of deep inguinal ring were measured. All the patients were operated under spinal cord anaesthesia. Results. The linear sizes of basic topographic and anatomical parameters of the inguinal channel in the elderly patients with hernia, received by ultrasonic imaging during the stage of the preoperative preparation and the morphometric research during the operative intervention have no significant difference. The height of the inguinal interval depends on the type of inguinal hernia in the elderly patients. The cumulative thickness of the muscles of the overhead wall of the inguinal channel in the elderly patients does not exceed 5 mm, out of them in 70 % cases it is within the limits of 4 мм. In inguinal hernia of IIIа type, the diameter of the deep ring of the inguinal channel is substantially less than that of IIIb type (p<0.05) and that of II type. Conclusion. Ultrasound imaging of the inguinal channel allows to objectively assess its basic topographic and anatomical parameters in hernia, and its results can be used for planning of the method of hernioplasty in elderly patients.

ультразвуковая визуализация, интраоперационная морфометрия, паховый канал, пожилой возрас, ultrasound imaging, intraoperative morphometry, inguinal canal, elderly age

1. Абоев, А.С. Хирургическое лечение паховых грыж / А. С.Абоев, А.А.Кульчиев // Хирургия. - 2006. - №3. - С. 55-58.

2. Жебровский, В.В.Хирургия грыж живота / В.В. Жебровский. - М.: МИА, 2005. - 400с.

3. Реброва, О.Ю. Статистический анализ медицинских данных. Применение пакета прикладных программ Statistica / О. Ю. Реброва. - М.: МедиаСфера, 2002. - 312 с.

4. Сравнительный анализ результатов операции I.L.Lichtenstein и CS-пластики при паховых грыжах / С.В.Шалашов [и др.] // Новости хирургии. - 2016. - Т.24, №5. - С.444-450.

5. Черных, А.В. Половые и возрастные различия в строении пахового промежутка / А.В. Черных, Е.Н. Любых, Е.Н. Закурдаев // Системный анализ и управление в биомедицинских системах. - 2014. - Т. 13, №1. - С.60-64.

6. Шуляренко, О.В. Сравнение тотальной экстраперитонеальной и трансабдоминальной преперитонеальной пластики паховой грыжи / О. В. Шуляренко // Новости хирургии. - 2016. - Т. 24, № 6. - С. 546-550.

7. Morales-Conde, S. Endoscopic surgeons preferences for inguinal: hernia repair: TEP, TAPP or OPEN / S. Morales-Conde, M. Socas, A. Fingerhut // Surg. Endosc. -2012. -Vol. 26, № 9. -P. 2639-2643.

8. The surgical strategy for laparoscopic approach in recurrent inguinal hernia repair: 213 cases report / X.Chen [et al.] // Zhonghua Wai Ke Za Zhi. - 2013. - Vol.51, № 9. - P.792-795.

9. Nyhus, L.M. Anatomic basis of hernioplasty / L.M.Nyhus // A classification vortrag, hernia 93, fdvanses of contraversies. An international perspective, Indionapolis. - 1993. - Vol.24, № 27. - P. 733-737.