Immediate and late follow-up results of auto- and alloplastic operations in inguinal hernias

Objective. To conduct a scientific investigation for comparative investigation of results of auto- and allohernioplastic operations. Materials and methods. The investigation was based on analysis of postoperative results in 400 patients, ageing 16 - 85 yrs old, to whom in Scientific Surgical Centre named after Acad. M. A. Topchibashev and the City of Shirvan Central Hospital in 2009-2019 yrs period surgical treatment for inguinal hernia was conducted. Depending on the procedure of hernioplasty applied, the patients were divided into two Groups. In a control one (n=200) the operations were performed, using open autohernioplasty only. In the main Group (n=200) open procedure and laparoscopic allohernioplasty, using different synthetic nets, were applied. Results. Comparative analysis of intraoperative, postoperative immediate and late follow-up results in the patients after auto- and allohernioplasty was done. In accordance to criteria of the intraoperative and immediate postoperative morbidity rate the statistically meaningful differences between two groups of patients were absent. Good late results of allohernioplasty were noted in (71.8 ± 3.41)%, satisfactory - in (17.2 ± 2.86)%, poor - in (11 ± 2.36)% patients (p<0.05); allohernioplasties - accordingly, in (80.2 ± 2.91)%, (16 ± 2.68)% and (3.8 ± 1.39)% patients (p<0.05). Comparative analysis done have shown the statistically much better results of allohernioplasty. Recurrences after allohernioplasty were observed in 3 times less frequently - 3.8%, and after autohernioplasty this index have constituted 11% (p < 0.05). Сomparative analysis of late follow-up results of various autohernioplastic methods have shown good results of Postemskyi method in (76.7 ± 7.72)% patients, and of Postempskyi method in our modification - in (88.9 ± 7.41)% patients. Good results of autoplasty in other methods were noted merely in equal quantity of the patients - in up to 70%, and statistically significant difference was absent. Conclusion. Basing on own results obtained, we recommend to perform autohernioplasty of the inguinal channel anterior wall in accordance to Girard-Sposokukotskyi method with Kimbarovskyi suture for oblique inguinal hernias, while in direct inguinal hernias, for strengthening of posterior wall, - Postempskyi method in our modification. In large and recurrent hernias in patients of middle and senile age it is expedient to apply a Lichtenstein plasty in our modification. Total extraperitoneal or transabdominal preperitoneal plasty is recommended if technical installments needed and the physician’n laparoscopic skills are available.

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Is alcohol septal ablation in women performed too late?

European Heart Journal ◽

10.1093/ehjci/ehaa946.2077 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

A Batzner ◽

D Aicha ◽

H Seggewiss

Keyword(s):

Hospital Stay ◽

Pacemaker Implantation ◽

Posterior Wall ◽

Hypertrophic Obstructive Cardiomyopathy ◽

Left Ventricular ◽

Icd Implantation ◽

Alcohol Septal Ablation ◽

Significant Difference ◽

Surgical Myectomy

Abstract Introduction Alcohol septal ablation (PTSMA) was introduced as interventional alternative to surgical myectomy for symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM) 25 years ago. As gender differences in diagnosis and treatment of HOCM are still unclear we analyzed baseline characteristics and results of PTSMA in a large single center cohort with respect to gender. Methods and results Between 05/2000 and 06/2017 first PTSMA in our center was performed in 952 patients with symptomatic HOCM. We treated less 388 (40.8%) women and 564 (59.2%) men. All patients underwent clinical follow-up. At the time of the intervention women were older (61.2±14.9 vs. 51.9±13.7 years; p<0.0001) and suffered more often from NYHA grade III/IV dyspnea (80.9% vs. 68.1%; p<0.0001), whereas angina pectoris was comparable in women (62.4%) and men (59.9%). Echocardiographic baseline gradients were comparable in women (rest 65.0±38.1 mmHg and Valsalva 106.2±45.7 mmHg) and men (rest 63.1±38.3 mmHg and Valsalva 103.6±42.8 mmHg). But, women had smaller diameters of the left atrium (44.3±6.9 vs. 47.2±6.5 mm; p<0001), maximal septum thickness (20.4±3.9 vs. 21.4±4.5 mm; p<0.01), and maximal thickness of the left ventricular posterior wall (12.7±2.8 vs. 13.5±2.9 mm; p<0.0001). In women, more septal branches (1.3±0.6 vs. 1.2±0.5; p<0.05) had to be tested to identify the target septal branch. The amount of injected alcohol was comparable (2.0±0, 4 in women vs. 2.1±0.4 ml in men). The maximum CK increase was lower in women (826.0±489.6 vs. 903.4±543.0 U / l; p<0.05). During hospital stay one woman and one man died, each (n.s.). The frequency of total AV blocks in the cathlab showed no significant difference between women (41.5%) and men (38.3%). Furthermore, the rate of permanent pacemaker implantation during hospital stay did not differ (12.1% in women vs. 9.4% in men). Follow-up periods of all patients showed no significant difference between women (5.7±4.9 years) and men (6.2±5.0 years). Overall, 37 (9.5%) women died during this period compared to only 33 (5.9%) men (p<0.05). But, cardiovascular causes of death were not significantly different between women (2.8%) and men (1.6%). Furthermore, the rates of surgical myectomy after failed PTSMA (1.3% in women vs. 2.3% in men), ICD implantation for primary prevention of sudden cardiac death according to current guidelines (4.1% in women vs. 5.9% in men) or pacemaker implantation (3.6% in women vs. 2.0% in men) showed no significant differences. Summary PTSMA in women with HOCM was performed at more advanced age with more pronounced symptoms compared to men. While there were no differences in acute outcomes, overall long-term mortality was higher in women without differences in cardiovascular mortality. Therefore, women may require more intensive diagnostic approaches in order not to miss the correct time for gradient reduction treatment. Funding Acknowledgement Type of funding source: None

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Standardized pulmonary vein isolation workflow to enclose veins with contiguous lesions: the multicentre VISTAX trial

EP Europace ◽

10.1093/europace/euaa157 ◽

2020 ◽

Vol 22 (11) ◽

pp. 1645-1652

Author(s):

Mattias Duytschaever ◽

Johan Vijgen ◽

Tom De Potter ◽

Daniel Scherr ◽

Hugo Van Herendael ◽

...

Keyword(s):

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Randomized Study ◽

Standard Of Care ◽

Posterior Wall ◽

Anterior Wall ◽

Atrial Arrhythmia ◽

Clinical Trial Registration ◽

First Pass

Abstract Aims To evaluate the safety and effectiveness of pulmonary vein isolation in paroxysmal atrial fibrillation (PAF) using a standardized workflow aiming to enclose the veins with contiguous and optimized radiofrequency lesions. Methods and results This multicentre, prospective, non-randomized study was conducted at 17 European sites. Pulmonary vein isolation was guided by VISITAG SURPOINT (VS target ≥550 on the anterior wall; ≥400 on the posterior wall) and intertag distance (≤6 mm). Atrial arrhythmia recurrence was stringently monitored with weekly and symptom-driven transtelephonic monitoring on top of standard-of-care monitoring (24-h Holter and 12-lead electrocardiogram at 3, 6, and 12 months follow-up). Three hundred and forty participants with drug refractory PAF were enrolled. Acute effectiveness (first-pass isolation proof to a 30-min wait period and adenosine challenge) was 82.4% [95% confidence interval (CI) 77.4–86.7%]. At 12-month follow-up, the rate of freedom from any documented atrial arrhythmia was 78.3% (95% CI 73.8–82.8%), while freedom from atrial arrhythmia by standard-of-care monitoring was 89.4% (95% CI 78.8–87.0%). Freedom fromrepeat ablations by the Kaplan–Meier analysis was 90.4% during 12 months of follow-up. Of the 34 patients with repeat ablations, 14 (41.2%) demonstrated full isolation of all pulmonary vein circles. Primary adverse event (PAE) rate was 3.6% (95% CI 1.9–6.3%). Conclusions The VISTAX trial demonstrated that a standardized PAF ablation workflow aiming for contiguous lesions leads to low rates of PAEs, high acute first-pass isolation rates, and 12-month freedom from arrhythmias approaching 80%. Further research is needed to improve the reproducibility of the outcomes across a wider range of centres. Clinical trial registration: ClinicalTrials.gov, number NCT03062046, https://clinicaltrials.gov/ct2/show/NCT03062046.

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External frontal sinusotomy and endoscopic repair of cerebrospinal fluid fistula in the posterior wall: preliminary report of a new technique

The Journal of Laryngology & Otology ◽

10.1017/s0022215111001150 ◽

2011 ◽

Vol 125 (8) ◽

pp. 802-806 ◽

Cited By ~ 6

Author(s):

P Thulasi Das ◽

D Balasubramanian

Keyword(s):

Cerebrospinal Fluid ◽

Frontal Sinus ◽

Posterior Wall ◽

Anterior Wall ◽

New Technique ◽

Endoscopic Repair ◽

Tertiary Referral Centre ◽

Cerebrospinal Fluid Leaks ◽

A New Technique

AbstractIntroduction:Cerebrospinal fluid rhinorrhoea is the abnormal leakage of cerebrospinal fluid into the nasal cavity. The posterior wall of the frontal sinus can be the site of such leakage. Traditionally, these leaks were repaired via external osteoplastic or neurosurgical approaches. Despite advances in instrumentation, it is difficult to manage superiorly or laterally placed defects endoscopically. We present a new technique of endoscopic repair of frontal sinus posterior wall defects, via access holes drilled in the anterior wall of the frontal sinus.Study design:Preliminary study involving patients presenting with frontal sinus cerebrospinal fluid leaks, with defects in the frontal sinus posterior wall, between 2006 and 2010.Setting:Patients were treated in a tertiary referral centre for nose and sinus diseases. Patient records were reviewed and analysed.Results:Nine patients underwent external frontal sinusotomy under endoscopic vision. Repair was successful in all cases, with no complications. Follow up ranged from three months to three years.Conclusion:External frontal sinusotomy and endoscopic repair is a simple, precise and cosmetically acceptable alternative to osteoplastic and major neurosurgical techniques for management of frontal sinus posterior wall defects. This new, previously undescribed technique enables otolaryngologists to play a role in managing such defects.

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Effect of Different Obturation Techniques on the Prognosis of Endodontic Therapy: A Retrospective Comparative Analysis

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1893 ◽

2016 ◽

Vol 17 (7) ◽

pp. 582-586 ◽

Cited By ~ 1

Author(s):

Jyoti Sachdeva ◽

Anurag Sarin ◽

Ajai Gupta ◽

Shobhit Sachdeva

Keyword(s):

Comparative Analysis ◽

Clinical Significance ◽

Analysis Of Variance ◽

Root Canal ◽

Root Canal Therapy ◽

Quality Of Treatment ◽

Significant Difference ◽

Level Of Significance

ABSTRACT Introduction Success of root canal therapy (RCT) is largely dependent upon the quality of biomechanical preparation and obturation of the pulp canal. Improperly cleaned or shaped root canal, regardless of the type of obturation method and obturating material, cannot lead to the success of endodontic therapy. Hence, we conducted a clinical comparative analysis of two obturating techniques. Materials and methods A total of 140 patients receiving RCT at the department of Endodontic were included in the present study. The average follow-up time for the patients was 29 months (18–38 months). Patients were grouped into two depending on the type of obturating technique used. Evaluation of the clinical and radiographic follow-up records of the patients was done and analysis was made. One-way analysis of variance (ANOVA) was used for assessing the level of significance. Results The average age of the patients undergoing obturation with carrier-based obturation (CO) technique and lateral compaction (LC) technique was 43 and 48 years respectively. While comparing failure and success of the teeth at the time of follow-up, nonsignificant results were obtained. Significant difference was seen, while comparing the presence of voids and type of teeth in which endodontic therapy was performed using different obturating techniques. Conclusion Endodontic therapy done with LC obturating technique or with CO technique shows prognostic difference on the outcome or quality of treatment therapy. Clinical significance Quality of obturation is more important rather than type while performing endodontic therapy for better prognosis. How to cite this article Sarin A, Gupta P, Sachdeva J, Gupta A, Sachdeva S, Nagpal R. Effect of Different Obturation Techniques on the Prognosis of Endodontic Therapy: A Retrospective Comparative Analysis. J Contemp Dent Pract 2016;17(7):582-586.

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Comparative analysis of transabdominal preperitoneal and total extraperitoneal plastic surgeries in inguinal hernia repair

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2017-176-4-48-50 ◽

2017 ◽

Vol 176 (4) ◽

pp. 48-50 ◽

Cited By ~ 1

Author(s):

A. S. Savin ◽

A. V. Khokhlov ◽

D. V. Dvoryankin

Keyword(s):

Inguinal Hernia ◽

Comparative Analysis ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Pain Syndrome ◽

Clinical Analysis ◽

Transabdominal Preperitoneal ◽

Total Extraperitoneal ◽

Significant Difference ◽

Made In

OBJECTIVE. Comparative analysis of transabdominal preperitoneal (TAPP) and total extraperitoneal (TEP) plastic surgeries was made in case of inguinal hernia repair. MATERIAL AND METHODS. Patients (n =236) underwent surgery at the period from 2012 till 2016. The TAPP was performed in 114 (48,3 %) patients and TEP was carried out in 122 (51,7 %). Clinical analysis of results was made in two groups. RESULTS. The research didn’t show any significant difference in the rate of intra- and postoperative complications and recurrences, but their structure varied. However, length of operation was less in case of one-sided hernia in TAPP group, although it was less in case of two-sided hernia in TEP group. An expression of pain syndrome was reliably lower in TEP group. CONCLUSIONS. Both methods demonstrated similar results and could be applied in treatment of inguinal hernias.

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Two bi-institutional prospective studies using intraperitoneal oxaliplatin with or without irinotecan during HIPEC following complete cytoreductive surgery for colorectal carcinomatosis.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.4_suppl.486 ◽

2011 ◽

Vol 29 (4_suppl) ◽

pp. 486-486 ◽

Cited By ~ 1

Author(s):

F. Quenet ◽

D. Goéré ◽

S. Mehta ◽

L. Roca ◽

F. Dumont ◽

...

Keyword(s):

Cytoreductive Surgery ◽

Prospective Studies ◽

New Combination ◽

Morbidity Rate ◽

Term Survival ◽

Significant Difference ◽

Colorectal Origin ◽

Lower Morbidity

486 Background: In treatment of peritoneal carcinomatosis (PC) of colorectal origin, studies combining cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy (HIPEC) have shown encouraging survival results. Intraperitoneal drugs usually used are mitomycin C or oxaliplatin in monotherapy. The aim of this study was to assess long-term survival in patients treated with a new combination of oxaliplatin and irinotecan (ox-irino) and to compare it with that obtained with oxaliplatin alone (ox-alone). Methods: Two bi-institutional prospective studies were carried out. All patients with PC who had undergone CRS with HIPEC using either ox-alone 460 mg/m2 or ox-irino (ox: 300 mg/m2 and irino: 200 mg/m2) from January 1998 to December 2007 were included. Results: 146 patient underwent CRS + HIPEC for PC from colorectal carcinoma. 103 patients received ox-irino and 43 patients received ox-alone HIPEC. The overall mortality rate was 4.1%. The overall morbidity rate was 47.2%. It was significantly lower in the ox-alone group compared to the ox-irino group (34.9% vs. 52.4%, p =0.05). After a median follow-up of 48.5 months, (95%CI 41.0-56.3), the median OS was 41 months (95%CI 32-60) and the median RFS was 15.7 months (95%CI 12-18). The median RFS of the ox-alone group was 16.8 months (95%CI 11-25) and was not significantly different from that of ox-irino group (15.7 months, 95%CI 11-18, p = 0.93). There was no significant difference between the median OS of the ox-alone group (40.83 months, 95%CI 29–61) and the ox-irino group (47 months, 95%CI 32-61, p = 0.94). At 5 years, the OS and the RFS rates were respectively 41.8% (95% CI 25.20-57.58) and 13.8% (95% CI 4.66-27.84) in the ox-alone group and 42.4% (95% CI 28.52-56.09) and 14.2% (95% CI 6.27-25.20) in the ox-irino group. Conclusions: This study confirms the interesting survival results of CRS + HIPEC to treat colorectal PC. 460 mg/m2 of oxaliplatin alone HIPEC is as efficient as 300 mg/m2 of oxaliplatin associated with 200 mg/m2 of irinotecan, but with lower morbidity. Ox-alone HIPEC, should remain the current gold standard. No significant financial relationships to disclose.

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Single Surgeon Experience With Repair of Occult Inguinal Hernias Using the TAPP Approach: A Prospective Study

International Surgery ◽

10.9738/intsurg-d-15-00089.1 ◽

2015 ◽

Vol 100 (11-12) ◽

pp. 1403-1407 ◽

Cited By ~ 1

Author(s):

Fatih Ciftci

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Inguinal Hernias ◽

Total Extraperitoneal ◽

Surgeon Experience ◽

Clinical Diagnoses ◽

Physical Examinations ◽

A Prospective Study

The trans-abdominal preperitoneal (TAPP) approach provides access to the contralateral groin for exploration and repair of occult hernias. Previous studies have shown that the total extraperitoneal (TEP) approach also provides access to the contralateral groin for inguinal hernia repair. The aim of the current study was to document the rate of contralateral occult inguinal hernias diagnosed during the TAPP procedure. Data from all cases of TAPP inguinal hernia repair in our hospital were recorded prospectively for 3 years. Follow-up appointments included physical examinations. A total of 302 patients underwent TAPP inguinal hernia repair. We excluded 3 patients from the study and 299 were included. A total of 204 (68%) patients were scheduled for unilateral hernia repair and contralateral occult hernias were detected in 44 (21%) patients in this group. Of the 74 patients scheduled for bilateral repair, 60 (81%) underwent bilateral repair. In the remaining 29 patients, the diagnosis was changed to unilateral hernia. In this group, unilateral hernia repair was planned along with the possibility of contralateral hernia in 18 (6%) patients. Of these patients, 5 (27%) were subsequently found to have contralateral defects, 1 of whom underwent femoral repair. Our clinical diagnoses were 78% accurate. Identifying the actual incidence of contralateral occult inguinal hernia will enhance the planning of the treatment preoperatively and favor resource allotment planning for utilization of the operating room. TAPP allows preoperative diagnosis and treatment of contralateral occult hernias, saving the patient from additional symptoms and reoperations.

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THE PROTECTIVE STATUS OF SUBTOTAL OBLITERATION OF ARTERIOVENOUS MALFORMATIONS AFTER RADIOSURGERY

Neurosurgery ◽

10.1227/01.neu.0000348546.47242.5d ◽

2009 ◽

Vol 65 (4) ◽

pp. 709-718 ◽

Cited By ~ 10

Author(s):

Zuair Abu-Salma ◽

François Nataf ◽

May Ghossoub ◽

Michel Schlienger ◽

Jean-François Meder ◽

...

Keyword(s):

Comparative Analysis ◽

Arteriovenous Malformations ◽

Statistical Difference ◽

Bleeding Rate ◽

Significant Statistical Difference ◽

Significant Difference ◽

Complete Obliteration

Abstract OBJECTIVE Arteriovenous malformations (AVMs) treated by radiosurgery with complete obliteration of the nidus but a persisting early draining vein on follow-up angiography can be termed subtotally obliterated. However, these are persistent circulating AVMs. The significance of these lesions, their hemorrhage rate, and their management are analyzed. METHODS In a series of 862 consecutive patients with AVMs treated by radiosurgery, 121 patients (14%) achieved subtotal obliteration (STO). The angiographic evolution and rate of obliteration were studied. The pretreatment angiographic features, dosimetric parameters, and postradiosurgery hemorrhage rate were compared with those in the rest of the treated population. Finally, the options for follow-up and treatment were analyzed. RESULTS Of 121 subtotally obliterated AVMs, the bleeding rate was 0%; 53% of patients achieved complete obliteration. This occurred in 71% of those who had STO at 1 year. In the cases in which STO was detected at 2, 3, and 4 years, total obliteration eventually occurred in 43%, 28.5%, and 0%, respectively. Comparative analysis with AVMs in which a part of the nidus persisted showed a significant difference in the bleeding rate. Except for volume, no significant statistical difference in angiographic and dosimetric parameters was found between the STO group and the rest of the studied population with residual nidus. Six cases received further treatment, resulting in 2 cures and 2 treatment-related complications. CONCLUSION Subtotally obliterated AVMs are different from other partially obliterated AVMs, with a 0% bleeding rate. Their complete obliteration is a function of delay of appearance on follow-up angiography. Invasive follow-up and further treatment of these AVMs do not seem warranted.

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Abstract 16778: Ventricular Tachycardia Ablation Outcomes Based on Scar Location in Patients With Ischemic Cardiomyopathy

Circulation ◽

10.1161/circ.142.suppl_3.16778 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Himanayani Mamillapalli ◽

Viorel G Florea ◽

Sravya Veligandla ◽

Smitha Murthy ◽

Jian-Ming Li ◽

...

Keyword(s):

Ventricular Tachycardia ◽

Ischemic Cardiomyopathy ◽

Pulseless Electrical Activity ◽

Anterior Wall ◽

Inferior Wall ◽

Ventricular Tachycardia Ablation ◽

Significant Difference ◽

Vt Ablation ◽

Lost To Follow Up

Introduction: Catheter ablation of ventricular tachycardia (VT) reduces implantable cardioverter defibrillator (ICD) therapies, improves hospitalization, and improves survival in patients with ischemic cardiomyopathy (ICM). Hypothesis: The goal of this study is to evaluate outcomes of patients with VT ablation by scar location in patients with ICM. Methods: Consecutive retrospective review of patients with ICM who underwent VT ablation at Minneapolis Veterans Affairs Health Care system between July 2008 and September 2019 were assessed for clinical outcomes. Results: Seventy-five patients with ICM underwent VT ablation during the study period. Average age was 67.6 ± 7 years old and 100% Male. Three patients were lost to follow up. Overall mortality was 53.3% and was highest in the inferior wall scar (IWS) group (Figure 1A, Table). Mean survival after ablation was 2.2 years. Most common cause of death was cardiac which included congestive heart failure, myocardial ischemia, and cardiac arrest (VT and pulseless electrical activity) (Figure 1B). On post-ablation echocardiogram, patients with anterior wall scar (AWS) had a lower mean ejection fraction (23%) compared to IWS group (30%) and this was statistically significant (p < 0.03, two-tailed t-test). The average number of ablations for recurrent VT was 1.4 with no significant difference between the groups. Fifty-five percent of patients were on anti-arrhythmics post ablation. Conclusions: VT ablation patients with IWS mediated VT have a trend towards higher mortality compared to those with AWS. This may be due to neuroregulatory pathway of VTs based on cardiac innervation.

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Modern Views on Surgical Anatomy of the Inguinal Canal at the Inguinal Hernias

Journal of New Medical Technologies ◽

10.12737/5913 ◽

2014 ◽

Vol 21 (3) ◽

pp. 112-115 ◽

Cited By ~ 1

Author(s):

Любых ◽

E. Lyubykh ◽

Черных ◽

A. Chernykh ◽

Закурдаев ◽

...

Keyword(s):

Inguinal Canal ◽

Posterior Wall ◽

Anterior Wall ◽

Surgical Anatomy ◽

Abdominal Muscles ◽

Anatomical Structures ◽

Anatomical Dissection ◽

Results Of Treatment ◽

Inguinal Hernias ◽

Internal Oblique

The purpose of this work is to study surgical anatomy in the patients with inguinal hernias of various kinds. Material. This work is performed on 41 corpses with inguinal hernias. Topographic and anatomical dissection of the inguinal canal with measurement of the linear parameters of anatomical structures, histological examination of specimens of the internal oblique abdominal muscles, the transverse fascia of the abdomen were carried out. Results. The authors have studied the structure of the posterior wall of the inguinal canal in the patients with oblique, direct, supravesical and inguinal-scrotal hernias. At persons with direct and supravesical inguinal hernias, a deformation is observed, mainly, in the medial inguinal fossa and supravesical fossa, showing great value inguinal gap, bland crescent aponeurosis, thinning of the transverse fascia of the abdomen. Increase of deep inguinal rings is observed in persons with oblique inguinal hernias. Dystrophy of abdominal muscles has always with inguinal hernias, and it is pronounced in the patients with inguinal-scrotal hernias. Conclusions. At surgical treatment of patients with direct inguinal hernias it is necessary to carry out correction of a posterior wall of the inguinal canal, in the patients with oblique inguinal hernias the anterior wall of the inguinal canal has to be surely restored. In the application of mesh materials in patients with large inguinal hernias, the results of treatment are doomed to fail, because the endoprosthesis only closes hernial wall that when failure of muscle function will clearly increase.

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