Assessment of Preoperative and Postoperative Changes in Corneal Astigmatism after Pterygium Excision by Different Techniques

2020 ◽  
Vol 9 (2) ◽  
pp. 1-4
Author(s):  
Madhavi Chevuturu
Keyword(s):  
Visual Acuity ◽  
Amniotic Membrane ◽  
Surgical Techniques ◽  
Corneal Astigmatism ◽  
Group Iii ◽  
Conjunctival Autograft ◽  
Postoperative Changes ◽  
Group I ◽  
Pterygium Excision ◽  
Group Ii

Background: Pterygium causes visual problems due to induced corneal astigmatism or direct encroachment onto the visual axis. The present study was conducted to compare preoperative and postoperative changes in corneal astigmatism after pterygium excision by different techniques. Subjects and Methods: The present study was conducted from May 2018 to August 20018 on 69 patients of age range 20-55 years of primary Pterygium. Patients were divided into three groups of 23 each. Group I was treated with bare sclera (BS) technique, Group II with conjunctival autograft (CAG) technique and Group III with amniotic membrane graft (AMG) technique. All the patients were preoperatively assessed for visual acuity, anterior and posterior segments, autorefraction, and autokeratometry. After surgery, the patients were recalled on day 5, 1 month, and 3 months for the analysis. Results: Uncorrected visual acuity (UCVA) preoperatively was 0.57, on the 5th day was 0.45 after 1 month was and after 3 months was 35. The mean preoperative astigmatism value in group I was 3.45, in group II was 3.52 and in group III was 3.49. Postoperative astigmatism value in group I was 1.60, in group II was 0.92 and in group III was 0.81. The difference was significant (P< 0.05). Conclusion: Authors found that amniotic membrane graft and a conjunctival autograft is better surgical techniques than bare sclera in reducing astigmatism.

scholarly journals Comparison Of Conjunctival Autograft And Combined Amniotic Membrane Mini-Simple Limbal Epithelial Transplantion After Primary Pterygium Excision

2020 ◽  
Author(s):  
ASHOK JHA ◽  
Abhay Simba
Keyword(s):  
Fibrin Glue ◽  
Amniotic Membrane ◽  
Operative Time ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Conjunctival Autograft ◽  
Group I ◽  
Pterygium Excision ◽  
Group Ii ◽  
Primary Pterygium

Abstract Background: To compare conjunctival autograft and combined amniotic membrane mini-simple limbal epithelial transplant after primary pterygium excision Methods: A prospective randomized interventional study was conducted on 264 eyes with Primary Pterygium.The patients were divided into Group I (conjunctival autograft) and Group II (mini-simple limbal epithelial transplant). 133 eyes in Group I underwent pterygium excision with a conjunctival autograft using fibrin glue. 131 eyes in Group II underwent mini Simple Limbal Epithelial Transplant with amniotic membrane using fibrin glue. Post-operatively, the patients were reviewed on day 1,3,7,14 & 30 and then at three,six and nine months. Primary outcome measure was the recurrence rate whereas the secondary outcome measures were the intraoperative time and other complications.Recurrence rate was calculated using Fisher’s exact test. Variables like age , preoperative BCVA , operative time and the dimensions of graft were compared using unpaired t test . Other baseline characteristics like gender, Laterality, grades of pterygium(I-III),Occupation and indication of surgery were expressed between the two groups using Pearson’s Chi-Square test. Results: Two hundred and thirty three eyes(118 in group I and 115 in group II) could complete nine months follow-up period. Recurrence was seen in 2(1.6%) cases in group I whereas 3 cases (2.6%) had recurrence in group II(p=0.681).Operative time for group (II) (20.33±1.28 min) was significantly higher (p<0.001) than group I (12.01±1.26). Graft displacement occurred in one case in group II (p=0.999). Conclusions: Despite a longer time,(p<0.001) mini-SLET seems to be a viable and equally effective alternative to CAG in the management of primary pterygium ,especially in cases where conjunctiva needs to be spared.Ethical Clearance Certificate Number : 29/MH/2015 dated 11 Aug 2015

scholarly journals Comparison of Visual Outcome and Morphologic Change between Different Surgical Techniques in Idiopathic Epiretinal Membrane Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Yo-Chen Chang ◽  
Chia-Ling Lee ◽  
Kuo-Jen Chen ◽  
Li-Yi Chiu ◽  
Tzu-En Kao ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Epiretinal Membrane ◽  
Surgical Techniques ◽  
Visual Outcome ◽  
Morphologic Change ◽  
Ilm Peeling ◽  
Idiopathic Epiretinal Membrane ◽  
Group Iii ◽  
Group I ◽  
Group Ii

Purpose. To investigate the morphological and functional outcomes of idiopathic epiretinal membrane (ERM) surgery between three different surgical techniques: ERM peeling only, whole-piece ILM peeling, and maculorrhexis ILM peeling. Patients and Methods. This is a retrospective, consecutive, and comparative study enrolling 60 patients from Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. Surgery performed between July 2011 and June 2012 was done with ERM peeling only (group I). ERM peeling and ILM peeling as a whole piece (group II) were performed between July 2012 and July 2013. Surgery performed between August 2013 and December 2014 was done with maculorrhexis ILM peeling (group III). Main outcome measures include visual acuity change (BCVA) and central foveal thickness (CFT). Results. At 12 months postoperation, the mean BCVA in group III was significantly better than in group I and group II. Comparison of CFT reduction between the three groups revealed significantly more reduction in group III than in group II at all postoperative follow-up periods. Eyes with restoration of foveal depression were observed in 52.6% in group I, 52.4% in group III, but only 20% of eyes in group II. None of the eyes in both ILM peeling groups encountered recurrence of macular pucker formation. Conclusion. All three techniques can achieve visual acuity improvement and macular thickness reduction. Maculorrhexis ILM peeling achieves more rapid improvement of visual function, better final visual outcome, and a higher rate of normal foveal contour than whole-piece ILM peeling.

scholarly journals Effects of doxorubicin associated with amniotic membrane stem cells in the treatment of canine inflammatory breast carcinoma (IPC-366) cells

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Jéssica Borghesi ◽  
Sara Caceres ◽  
Lara Carolina Mario ◽  
Angela Alonso-Diez ◽  
Ana Carolina Silveira Rabelo ◽  
...  
Keyword(s):  
Stem Cells ◽  
Flow Cytometry ◽  
Amniotic Membrane ◽  
Triple Negative ◽  
Cellular Growth ◽  
Control Group ◽  
Group Iii ◽  
Chemotherapy Drugs ◽  
Group I ◽  
Group Ii

Abstract Background Tumours in mammary glands represent the most common neoplasia in bitches, as in humans. This high incidence results in part from the stimulation of sex hormones on these glands. Among mammary tumours, inflammatory carcinoma is the most aggressive, presenting a poor prognosis to surgical treatment and chemotherapy. One of the most widely used chemotherapy drugs for breast cancer treatment is doxorubicin (DOXO). Alternative therapies have been introduced in order to assist in these treatments; studies on treatments using stem cells have emerged, since they have anti-inflammatory and immunomodulatory properties. The aim of this study was to evaluate the effects of DOXO and canine amniotic membrane stem cells (AMCs) on the triple-negative canine inflammatory mammary carcinoma cell line IPC-366. Methods Four experimental groups were analysed: a control group without treatment; Group I with DOXO, Group II with AMC and Group III with an association of DOXO and AMCs. We performed the MTT assay with DOXO in order to select the best concentration for the experiments. The growth curve was performed with all groups (I-III) in order to verify the potential of treatments to reduce the growth of IPC-366. For the cell cycle, all groups (I-III) were tested using propidium iodide. While in the flow cytometry, antibodies to progesterone receptor (PR), estrogen receptor (ER), PCNA, VEGF, IL-10 and TGF-β1 were used. For steroidogenic pathway hormones, an ELISA assay was performed. Results The results showed that cells treated with 10 µg/mL DOXO showed a 71.64% reduction in cellular growth after 72 h of treatment. Reductions in the expression of VEGF and PCNA-3 were observed by flow cytometry in all treatments when compared to the control. The intracellular levels of ERs were also significantly increased in Group III (4.67% vs. 27.1%). Regarding to the levels of steroid hormones, significant increases in the levels of estradiol (E2) and estrone sulphate (S04E1) were observed in Groups I and III. On the other hand, Group II did not show differences in steroid hormone levels in relation to the control. We conclude that the association of DOXO with AMCs (Group III) promoted a reduction in cell growth and in the expression of proteins related to proliferation and angiogenesis in IPC-366 triple-negative cells. Conclusions This treatment promoted ER positive expression, suggesting that the accumulated oestrogen conducted these cells to a synergistic state, rendering these tumour cells responsive to ERs and susceptible to new hormonal cancer therapies.

Prospective Evaluation of Intravitreal Triamcinolone Acetonide Injection in Macular Edema Associated with Retinal Vascular Disorders

2005 ◽  
Vol 15 (5) ◽  
pp. 619-626 ◽  
Author(s):  
H.K. Tewari ◽  
P. Sony ◽  
R. Chawla ◽  
S.P. Garg ◽  
P. Venkatesh
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Triamcinolone Acetonide ◽  
Macular Thickness ◽  
Intravitreal Triamcinolone ◽  
Group Iii ◽  
Vein Occlusion ◽  
Group I ◽  
Group Ii

Purpose To evaluate the effect of intravitreal triamcinolone acetonide on visual acuity and macular thickness using optical coherence tomography (OCT) in macular edema associated with various retinal vascular disorders. Methods This prospective nonrandomized clinical interventional study included 81 eyes (76 patients) comprised of Group I, 57 eyes (51 patients) with diabetic macular edema; Group II, 10 eyes (10 patients) with branch retinal vein occlusion; and Group III, 13 eyes (13 patients) with central retinal vein occlusion. All eyes received an intravitreal injection of 4 mg triamcinolone acetonide (with the solvent) in the operation theater under sterile conditions. Results Mean preinjection central macular thickness was 531.84±132 μm in Group I, 458.4±149 μm in Group II, and 750.81±148 μm in Group III. All groups showed a statistically significant decrease in mean central macular thickness at 1 month (300.7±119 μM in Group I, 218.2±99 μm in Group II, and 210.5 ±56 μm in Group III) and 3 months (253.19±109 μm in Group I, 187±47 μm in Group II, and 182±50 μm in Group III) after injection (p<0.05). Mean follow-up was 22±2.4 weeks. Mean visual acuity increased in all three groups (preoperative visual acuity in Group I, 1.2±0.4 logMAR units; Group II, 1.24±0.5 logMAR units; Group III, 1.1 ±0.4 logMAR units; 1 month postinjection in Group I, 0.88±0.3 logMAR units; Group II, 0.67±0.3 logMAR units; Group III, 0.86±0.4 logMAR units; 3 months postinjection in Group I, 0.84±0.4 logMAR units; Group II, 0.59±0.3 logMAR units; Group III, 0.82±0.5 logMAR units) (p<0.05). Forty-one eyes completed 6 months and 20 eyes completed 9 months follow-up. Twelve of 20 (41%) eyes in Group I, 2/6 (33%) eyes in Group II, 3/6 (50%) eyes in Group III, and 8/15 (53%) eyes in Group I, 1/3 (33%) eyes in Group II, and 2/2 (100%) eyes in Group III developed recurrence of macular edema with worsening of visual acuity at 6 and 9 months, respectively. Thirty-three (40.7%) eyes developed IOP elevation (at least one reading > 24 mmHg). One eye developed infective endophthalmitis. Conclusions Intravitreal injection of triamcinolone acetonide may be considered as an effective treatment for reducing macular thickening due to diffuse diabetic macular edema, venous occlusion associated macular edema, and may result in increase in visual acuity at least in the short term. Further follow-up and analysis is required to demonstrate its long-term efficacy.

scholarly journals The Long-Term Results of ReLEX® SMILE Depending on the Degree of the Corrected Myopia

2020 ◽  
Vol 17 (4) ◽  
pp. 711-718
Author(s):  
O. A. Klokova ◽  
R. O. Damashauskas ◽  
S. V. Kostenev ◽  
E. N. Kalaidin
Keyword(s):  
Visual Acuity ◽  
Laser System ◽  
Study Groups ◽  
Individual Characteristics ◽  
Long Term Results ◽  
Efficiency Coefficient ◽  
Group Iii ◽  
Group I ◽  
Group Ii

The purpose: prospective study of the long-term refractive and visual results of ReLEx® SMILE, depending on the degree of corrected myopia.Material and methods. The three study groups included 71 patients; the mean age was 26.48 ± 5.5 years. Group I consisted of 20 patients (39 eyes) mean SE –2.62 ± 0.87 D, group II — 26 patients (51 eyes), mean SE 4.68 ± 0.74 D, Group III — 25 patients (47 eyes), mean SE 6.88 ± 0.72 D. All patients underwent femtolaser correction of myopia using the ReLEx® SMILE method with the VisuMax™ laser system (Carl Zeiss Meditec AG).Results. Uncorrected visual acuity of 09 — 1.0 was noted in 34 eyes (87.2 %) in group I, in II — in 43 eyes (84.3 %), in 37 eyes (78.7 %) in group III. The efficiency coefficient was 1.0 in groups I — II and 0.89 in group III. There was no decrease in corrected visual acuity (CVA) during the correction of mild and moderate myopia, in group III it was recorded by 0.1 in two cases (4 %), by 0.2 in one case (2 %), the safety factor in I — II groups 1.0, in III 0,89. Two years after ReLEx® SMILE, refraction of ± 0.5 D from planned in the study groups was achieved, respectively, in 94.9, 88.2, 76.6 % of cases, ± 1.0 D in 100 % of cases in I, II groups, in 97 % of cases in III group. The predictability coefficient was 0.95 in group I, 0.88 in group II, and 0.77 in group III. Refractive regression compared with the results 1 month postoperatively was 0.08 D in group I, 0.1 D in group II, and 0.16 D in group III. Analysis of the long-term results of ReLEx® SMILE allows us to conclude: the method is safe and effective, provides high predictability of refractive results in correcting various degrees of myopia. Further study of the long-term results of the operation, the creation and use of nomograms, taking into account the individual characteristics of the cornea, will improve the predictability and stability of refractive results in the correction of high myopia. 

scholarly journals Development of an algorithm for the clinical and instrumental diagnosis of non-compression lumbar pain syndromes to optimize the use of puncture surgical techniques

2020 ◽  
pp. 27-34
Author(s):  
A. A. Kalinin ◽  
A. K. Okoneshnikova ◽  
Yu. Ya. Pestryakov ◽  
V. V. Shepelev ◽  
V. A. Byvaltsev
Keyword(s):  
Lumbar Spine ◽  
Surgical Techniques ◽  
Degenerative Changes ◽  
Lumbar Pain ◽  
Group Iii ◽  
Pain Syndromes ◽  
Group I ◽  
Neuroimaging Data ◽  
Group Ii ◽  
Stimulation Of

Background. Pain syndromes developing as a result of degeneration of the lumbar segments of the spine constitute a significant problem in modern vertebrology. The results of the application of preoperative diagnostic provocative tests are contradictory, and therefore the mixed effectiveness of puncture surgical techniques is recorded.Objective. To develop an algorithm for the clinical and instrumental diagnosis of non-compression lumbar pain syndromes to optimize the use of puncture surgical techniques.Material and Methods. The study included 923 patients who underwent provocative diagnostic techniques on the intervertebral disk (IVD) and the arched joints (AJ) between 2012 and 2017. Taking into account clinical and instrumental data, the following are made: in group I (n=246) – laser IVD nucleoplasty, in group II (n = 287) – laser denervation of FJ, in group III (n = 390) – simultaneous use of laser exposure to IVD and AJ. We analyzed the dynamics of the level of pain in the lumbar spine and lower extremities according to The Visual Analogue Scale and quality of life according to The Short Form-36 (SF-36) questionnaire.Results. When performing provocative diagnostic tests, the minimum number of adverse effects was recorded: 3.2% in group I, 2.4% in group II, and 2.1% in group III. After puncture methods of surgical treatment, a significant persistent decrease in the severity of preoperative pain was observed both in the lumbar spine (p = 0.002, p = 0.005 and p = 0.004, respectively) and in the lower extremities (p = 0.003, p = 0.001 and p = 0.005, respectively) A significant improvement in the physical and psychological components of health was also established in group I (p = 0.02 and p = 0.01, respectively), in group II (p = 0.01 and p = 0.03, respectively) and group III (p = 0.03 and p = 0.02, respectively).Conclusion. In the presence of neuroimaging parameters of IVD according to C. Pfirrmann III–IV and protrusion size 4–6 mm, minimal degenerative changes in the AJ according to A. Fujiwara I–II and D. Weishaupt I–II, as well as a positive disruption test, it is possible to perform laser nucleoplasty. In case of detection of neuroimaging data of IVD according to C. Pfirrmann I–II and protrusion size less than 4 mm, moderately pronounced degenerative changes in the AJ according to A. Fujiwara II–III and D. Weishaupt II–III, as well as positive paraarticular stimulation of AJ, laser denervation of AJ is recommended. When determining, according to neuroimaging data, moderate degenerative changes in IVD according to C. Pfirrmann over III and protrusion size 4–6 mm, as well as degeneration of AJ according to A. Fujiwara more than II and D. Weishaupt more than II, positive of samples and paraarticular stimulation of AJ, it is advisable to perform simultaneous surgical intervention in the volume of laser IVD nucleoplasty and laser denervation of AJ.

scholarly journals Keratometric changes after pterygium excision

2020 ◽  
Vol 8 (5) ◽  
pp. 1724
Author(s):  
Sharda Punjabi ◽  
Appurv Kachhwaha
Keyword(s):  
Visual Acuity ◽  
Uv Light ◽  
Light Exposure ◽  
Autologous Blood ◽  
Corneal Astigmatism ◽  
P Value ◽  
Ocular Surgery ◽  
Conjunctival Autograft ◽  
Pterygium Excision ◽  
Primary Pterygium

Background: A pterygium is a wing-shaped growth of conjunctiva and fibrovascular tissue on the superficial cornea. The pathogenesis of pterygia is strongly correlated with UV light exposure and environmental factors. The prevalence of pterygia increases steadily with proximity to the equator, and the condition is more common in men than women. It is well established fact that before entering the optical zone pterygium causes flattening of the cornea in horizontal meridian with the more normal side of the cornea usually temporally, resulting in with-the-rule astigmatism.Methods: The study included 80 patients of primary pterygium who underwent pterygium excision with conjunctival autograft adhered by autologous blood surgery. After performing routine ocular examination which includes visual acuity without and with pinhole and pre-operative keratomery was assessed by autokeratorefractometer. Repeat examination was performed after 6 weeks of surgery. Patients with recurrent pterygium, pseudo-pterygium, and history of previous ocular surgery were excluded.Results: The pre‑ and postoperative corneal astigmatism were compared after 6 weeks of surgery. The changes in corneal astigmatism were statistically significant p value <0.001. The preoperative mean corneal astigmatism of 3.41 D was reduced to 1.59 D (p value <0.001) 6 weeks after surgery, but maximum change in astigmatism was seen in Grade IV >Grade III >Grade II >Grade I.Conclusions: Primary pterygium of all grades treated with well accepted technique pterygium excision with conjunctival autograft with autologous blood gives promising results in terms of improvement in corneal astigmatism and hence visual acuity as well.

scholarly journals Plastic for diaphragmal hernia

2021 ◽  
Author(s):  
I. I. Rosenfeld
Keyword(s):  
Plastic Surgery ◽  
Surgical Techniques ◽  
Study Groups ◽  
Surgical Interventions ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
The Difference ◽  
Comparison Of The Results ◽  
Diaphragmatic Hernias

Aim. The article discusses the results of a study using a patented method of two-layer laparoscopic repair of large and giant hiatal hernias using a biocarbon implant in comparison with other surgical techniques.Materials and methods. 716 patients were divided into 3 study groups based on the area of the size of the esophageal hernia defect: group I (314 patients) – with small (less than 5 cm2) and medium (5–10 cm2) hiatal hernias, that is, up to 10 cm2, which hernioplasty was performed only by the method of posterior cruraphy; group II (323 patients) – with large hernias 10–20 cm2: subgroup 1 (92 patients) underwent posterior cruraphy, subgroup 2 (231 patients) – alloplasty. Depending on the alloplasty technique, subgroup 2, in turn, was divided: subgroup A (89 people) – hernioplasty with a polypropylene implant and subgroup B (142 people) – hernioplasty with a medical biocarbon construction. Study group III (79 patients) – patients with giant diaphragmatic hernias of more than 20 cm2 using alloplasty: subgroup A (29 people) – hernioplasty with a polypropylene implant and subgroup B (50 patients) – alloplasty with a medical biocarbon construction.Results. When comparing group I with subgroup 1 of group II, the following results were obtained. Statistically significant differences were found in the degrees and types of diaphragmatic hernias. The average age of patients and statistical differences for it were insignificant. When comparing subgroup 1 with subgroup 2 of group II, statistically insignificant differences were found in the degrees and types of hiatal hernias. The difference in the average age of patients was also statistically insignificant. The difference in the average age of patients was also statistically insignificant. When comparing subgroup A with subgroup B of group II, statistically insignificant differences were found among themselves in the degrees and types of hiatal hernias. When comparing subgroup 2 of group II with group III, the difference turned out to be statistically significant in the distribution of patients by types and degrees of diaphragmatic hernias. When comparing subgroup A with subgroup B of group III by degrees and types of hiatal hernias, statistically insignificant differences were revealed.Conclusion. Posterior cruraphia in small and medium diaphragmatic hernias had significant statistical differences in types and degrees compared to that in large hernias, as well as in the average area of the hernial defect. Posterior cruraphia with hernioplasty in large hiatal hernias did not differ statistically significantly according to any of the criteria. Plastic surgery with a polypropylene implant with alloplasty of a biocarbon implant for large hernias did not differ significantly according to any of the criteria. Hernioplasty for large hiatal hernias, when compared with giant hernias, differed significantly only in the degree and type, as well as in the area of the hernial defect. «Onlay» plastic surgery with a polypropylene implant with alloplasty of biocarbon structures for giant hernias did not differ significantly according to any of the criteria, except for gender distribution, which did not have significant fundamental significance, which made it possible to make a more correct comparison of the results of surgical interventions in these research subgroups.

scholarly journals Plastic for diaphragmal hernia

2021 ◽  
Author(s):  
I. I. Rosenfeld
Keyword(s):  
Plastic Surgery ◽  
Surgical Techniques ◽  
Study Groups ◽  
Surgical Interventions ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
The Difference ◽  
Comparison Of The Results ◽  
Diaphragmatic Hernias

The article discusses the results of a study using a patented method of two-layer laparoscopic repair of large and giant hiatal hernias using a biocarbon implant in comparison with other surgical techniques.Materials and methods. 716 patients were divided into 3 study groups based on the area of the size of the esophageal hernia defect: group I (314 patients) – with small (less than 5 cm2) and medium (5–10 cm2) hiatal hernias, that is, up to 10 cm2, which hernioplasty was performed only by the method of posterior cruraphy; group II (323 patients) – with large hernias 10–20 cm2: subgroup 1 (92 patients) underwent posterior cruraphy, subgroup 2 (231 patients) – alloplasty. Depending on the alloplasty technique, subgroup 2, in turn, was divided: subgroup A (89 people) – hernioplasty with a polypropylene implant and subgroup B (142 people) – hernioplasty with a medical biocarbon construction. Study group III (79 patients) – patients with giant diaphragmatic hernias of more than 20 cm2 using alloplasty: subgroup A (29 people) – hernioplasty with a polypropylene implant and subgroup B (50 patients) – alloplasty with a medical biocarbon construction.Results. When comparing group Ӏ with subgroup 1 of group II, the following results were obtained. Statistically significant differences were found in the degrees and types of diaphragmatic hernias. The average age of patients and statistical differences for it were insignificant. When comparing subgroup 1 with subgroup 2 of group II, statistically insignificant differences were found in the degrees and types of hiatal hernias. The difference in the average age of patients was also statistically insignificant. The difference in the average age of patients was also statistically insignificant. When comparing subgroup A with subgroup B of group II, statistically insignificant differences were found among themselves in the degrees and types of hiatal hernias. When comparing subgroup 2 of group II with group III, the difference turned out to be statistically significant in the distribution of patients by types and degrees of diaphragmatic hernias. When comparing subgroup A with subgroup B of group III by degrees and types of hiatal hernias, statistically insignificant differences were revealed.Conclusion. Posterior cruraphia in small and medium diaphragmatic hernias had significant statistical differences in types and degrees compared to that in large hernias, as well as in the average area of the hernial defect. Posterior cruraphia with hernioplasty in large hiatal hernias did not differ statistically significantly according to any of the criteria. Plastic surgery with a polypropylene implant with alloplasty of a biocarbon implant for large hernias did not differ significantly according to any of the criteria. Hernioplasty for large hiatal hernias, when compared with giant hernias, differed significantly only in the degree and type, as well as in the area of the hernial defect. «Onlay» plastic surgery with a polypropylene implant with alloplasty of biocarbon structures for giant hernias did not differ significantly according to any of the criteria, except for gender distribution, which did not have significant fundamental significance, which made it possible to make a more correct comparison of the results of surgical interventions in these research subgroups.

scholarly journals Plastic and cruroraphy for chiatal hernia

2021 ◽  
Vol 23 (5) ◽  
pp. 453-456
Author(s):  
Igor I. Rozenfel'd ◽  
Keyword(s):  
Plastic Surgery ◽  
Surgical Techniques ◽  
Study Groups ◽  
Surgical Interventions ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
The Difference ◽  
Comparison Of The Results ◽  
Diaphragmatic Hernias

Aim. The article discusses the results of a study using a patented method of two-layer laparoscopic repair of large and giant hiatal hernias using a biocarbon implant in comparison with other surgical techniques. Materials and methods. 716 patients were divided into 3 study groups based on the area of the size of the esophageal hernia defect: group I (314 patients) – with small (less than 5 cm2) and medium (5–10 cm2) hiatal hernias, that is, up to 10 cm2, which hernioplasty was performed only by the method of posterior cruraphy; group II (323 patients) – with large hernias 10–20 cm2: subgroup 1 (92 patients) underwent posterior cruraphy, subgroup 2 (231 patients) – alloplasty. Depending on the alloplasty technique, subgroup 2, in turn, was divided: subgroup A (89 people) – hernioplasty with a polypropylene implant and subgroup B (142 people) – hernioplasty with a medical biocarbon construction. Study group III (79 patients) – patients with giant diaphragmatic hernias of more than 20 cm2 using alloplasty: subgroup A (29 people) – hernioplasty with a polypropylene implant and subgroup B (50 patients) – alloplasty with a medical biocarbon construction. Results. When comparing group I with subgroup 1 of group II, the following results were obtained. Statistically significant differences were found in the degrees and types of diaphragmatic hernias. The average age of patients and statistical differences for it were insignificant. When comparing subgroup 1 with subgroup 2 of group II, statistically insignificant differences were found in the degrees and types of hiatal hernias. The difference in the average age of patients was also statistically insignificant. The difference in the average age of patients was also statistically insignificant. When comparing subgroup A with subgroup B of group II, statistically insignificant differences were found among themselves in the degrees and types of hiatal hernias. When comparing subgroup 2 of group II with group III, the difference turned out to be statistically significant in the distribution of patients by types and degrees of diaphragmatic hernias. When comparing subgroup A with subgroup B of group III by degrees and types of hiatal hernias, statistically insignificant differences were revealed. Conclusion. Posterior cruraphia in small and medium diaphragmatic hernias had significant statistical differences in types and degrees compared to that in large hernias, as well as in the average area of the hernial defect. Posterior cruraphia with hernioplasty in large hiatal hernias did not differ statistically significantly according to any of the criteria. Plastic surgery with a polypropylene implant with alloplasty of a biocarbon implant for large hernias did not differ significantly according to any of the criteria. Hernioplasty for large hiatal hernias, when compared with giant hernias, differed significantly only in the degree and type, as well as in the area of the hernial defect. Onlay plastic surgery with a polypropylene implant with alloplasty of biocarbon structures for giant hernias did not differ significantly according to any of the criteria, except for gender distribution, which did not have significant fundamental significance, which made it possible to make a more correct comparison of the results of surgical interventions in these research subgroups.

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