Comparison of Large-Gauge Needle, Corneal Knife, and No. 11 Blade for Percutaneous Achillotomy

Background In the Ponseti technique, the residual equinus deformity is corrected with percutaneous tenotomy. This experimental study aimed to compare the safety and effectiveness of a large-gauge needle, a corneal knife, and a No. 11 blade in percutaneous achillotomy performed in rats. Methods Ninety Achilles tendons of 45 Sprague-Dawley rats were analyzed, following division into three study groups. In the study, group I (needle), group II (corneal knife), and group III (No. 11 blade) were compared on the basis of bleeding, incision length, requirement for primary suture, range of motion, and resulting neurovascular injury at day 0. Moreover, the groups were compared in terms of range of motion, macroscopic and microscopic adhesions, and tenocyte morphology at days 21 and 42 postoperatively. Results On day 0, one suture was required in group III, whereas in groups I and II, no sutures were required. Postoperative bleeding was greater in group III and similar in groups I and II. Neurovascular injury was not observed in any of the groups. Three incomplete tenotomies were observed in group III and one incomplete tenotomy was observed in group II. Importantly, all tenotomies were complete in group I. In all groups, the range of motion was similar. The macroscopic adhesion score revealed high adhesion in group III (P = .009). According to Tang's criteria, microscopic adhesion was significantly higher on day 21 in group III compared with the other groups (P <0.001). No significant differences were observed in tenocyte morphology based on the Bonar criteria (P = .850). Conclusions In the results obtained from this animal study, we observed less bleeding, less adhesion, and less incomplete tenotomy in the large-gauge needle and corneal knife groups compared with the No. 11 blade group during the percutaneous Achilles tenotomy performed in rats.

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Remifentanil and Propofol Sedation for Retrobulbar Nerve Block

Anaesthesia and Intensive Care ◽

10.1177/0310057x0203000405 ◽

2002 ◽

Vol 30 (4) ◽

pp. 433-437 ◽

Cited By ~ 17

Author(s):

V. Rewari ◽

R. Madan ◽

H. L. Kaul ◽

L. Kumar

Keyword(s):

Adverse Effects ◽

Respiratory Depression ◽

Study Groups ◽

Group Iv ◽

Control Group ◽

Group Iii ◽

Group I ◽

Retrobulbar Block ◽

Significant Movement ◽

Group Ii

We studied remifentanil and propofol for analgesia and sedation during the placement of an ophthalmic block. Eighty ASA I or II patients undergoing elective cataract surgery under a retrobulbar block in a rural camp setting were included in the study. Patients were randomly divided into four groups and received different drug combinations as follows: Group I—remifentanil 1 μg/kg, Group II—remifentanil 0.5 μg/kg and propofol 0.5 mg/kg, Group III— remifentanil 1 μg/kg with propofol 0.5 mg/kg and Group IV—saline 0.1 ml/kg. Patients were observed for degree of movement, sedation, pain, recall and respiratory depression. No patient in the study groups reported pain or displayed movement whereas most of the patients in the control group had significant pain during the placement of the block. Also, seven (35%) patients in the control group showed significant movement which may have led to failure of block in two patients and retrobulbar haemorrhage in one patient. Incidence of significant respiratory depression was maximum in Group III patients (60%), followed by Group I (20%) and least in Group II (5%). All patients in the study groups remained cooperative and obeyed commands except four patients in group III (OAA/S-4). Postoperatively, other than the control group, recall was maximum in Group I (55%) and least in Group II (5%). Hence, a combination of remifentanil 0.5 μg/kg with propofol 0.5 mg/kg as a bolus was considered to provide excellent relief of pain and anxiety with least adverse effects for the placement of ophthalmic blocks.

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

Ophthalmology in Russia ◽

10.18008/1816-5095-2020-4-711-718 ◽

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.

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Ultrastructural evaluation of urine alkalinization versus hydration on colistin-induced nephrotoxicity

Human & Experimental Toxicology ◽

10.1177/0960327119862339 ◽

2019 ◽

Vol 38 (12) ◽

pp. 1366-1377

Author(s):

B Korucu ◽

I Unal ◽

M Pekcan ◽

AC Inkaya ◽

H Yeter ◽

...

Keyword(s):

Electron Microscopy ◽

Drinking Water ◽

Weak Acid ◽

Group Iv ◽

Ultrastructural Changes ◽

Sprague Dawley ◽

Group Iii ◽

Group I ◽

Urine Alkalinization ◽

Group Ii

Objectives: Colistin is a vital antibiotic used in multidrug-resistant infections. Its most important side effect is nephrotoxicity. Colistin is a weak acid. This study aims to evaluate whether urine alkalinization is protective in the nephrotoxicity of colistin. Methods: Twenty-eight male Sprague-Dawley rats were divided into groups. Group I ( n = 4) was injected with intramuscular distilled water twice a day for 7 days. Group II ( n = 8) was injected with 750,000 IU/kg/day colistin for 7 days. Group III ( n = 8) was injected with the same dose of colistin after their urinary pH was ≥7 through the addition of bicarbonate in their drinking water. Group IV ( n = 8) was injected with the same dose of colistin after their urine density fell below 1010 through the addition of NaCl molds in their food and 12.6 mg/L NaCl in their drinking water. Results: According to tubular degenerations (scored 0–5), group I scored 0, group II scored 4.25, group III scored 2, and group IV scored 1.5. In groups III and IV, protection was achieved ( p = 0.001). The bicarbonate group was not superior to the NaCl group ( p = 0.789). In transmission electron microscopy, group III had more microvilli integrity and autophagic vacuoles compared to group IV. Group IV had mitochondrial swelling and cristae lysis. A lower urine density was related to lower tubular scores ( p = 0.001). Conclusions: Colistin was highly nephrotoxic without protection. Light microscopy findings revealed that urinary alkalinization and NaCl hydration were similarly protective. Urine alkalinization further prevents ultrastructural changes as revealed by electron microscopy.

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Interleukin-1β, interleukin-6 and tumour necrosis factor-alpha levels in blood and saliva in hypothyroidism accompanied with periodontitis

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v10i2.539 ◽

2019 ◽

Vol 10 (2) ◽

pp. 1361-1366

Author(s):

Sahar H. Al-Hindawi ◽

Batool Hassan Al-Ghurabi

Keyword(s):

Immune Response ◽

Periodontal Disease ◽

Study Groups ◽

Control Group ◽

Necrosis Factor Alpha ◽

Group Iii ◽

Group I ◽

Salivary Level ◽

Tnf Α ◽

Group Ii

Relationship between thyroid dysfunction and periodontal disease has been mediated through an immune response. Cytokines are implicated in the initiation, consequences of immune response and a crucial role in the pathogenesis of thyroid disease, directly target thyroid follicular cells; and in the development and progression of periodontitis. This study aimed to detect cytokines levels which known to be associated with periodontitis in serum and saliva, to test the hypothesis that hypothyroidism influences the levels of biomarkers of periodontitis. Samples were collected from sixty patients with hypothyroid age ranged (20-64) years, thirty of patients were without periodontitis (group I) and 30 with periodontal disease (II); moreover, 30 subjects considered as control (group III) with age (20-53) years. Detection of cytokines was performed by ELISA. The results showed a significant elevation in serum and salivary levels of IL-1β (P<0.001) among patients’ groups (I and II) as compared to group III, as well IL-1β increase significantly in group II (P<0.001) than in group I and also than group III. There are non-significant differences (P>0.05) in serum level of IL-6 and TNF-α and salivary levels of TNF-α among all study groups. Nevertheless, the salivary level of IL-6 is increased significantly (P<0.05) in group II as compared with group I and group III, and their non-significant differences (P<0.05) between groups I and III. The present finding proposed that hypothyroidism might encourage periodontitis development; as well as serum and salivary levels of IL-1β, with salivary IL-6 may represent important biomarkers for the early detection of periodontitis in hypothyroid patients.

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COMPARATIVE CHARACTERISTICS OF DIFFERENT METHODS OF TREATMENT OF CHRONIC COMPLICATED HEMORRHOIDS

Kharkiv Surgical School ◽

10.37699/2308-7005.4.2021.07 ◽

2021 ◽

pp. 36-42

Author(s):

A. V. Makukha ◽

M. A. Kashtalyan ◽

V. Yu. Shapovalov ◽

R. V. Enin

Keyword(s):

Surgical Treatment ◽

Postoperative Complications ◽

Postoperative Bleeding ◽

Stage Ii ◽

Group Iii ◽

Early Postoperative Complications ◽

Group I ◽

External Component ◽

Group Ii ◽

Methods Of Treatment

Abstract. Introduction. In recent years, a method of surgical treatment of hemorrhoids by the method of ligation of hemorrhoidal arteries under Doppler control (THD technique), as well as with additional rectoanal reconstruction (HAL-RAR) has been developed and widely used. The aim of the study. The aim of our study was to compare methods of treatment of chronic complicated hemorrhoids stage II-III: classical Milligan-Morgan surgery, staple mucopexy according to Longo, as well as a combined technique: Doppler desarterization by HAL-RAR with additional removal of the external anodermal component. Materials and methods. In the clinic of coloproctology of Military medical: Clinical Center of the Southern Region of Odessa performed an analysis of three groups of patients for the period from 2011 to 2021, who underwent hemorrhoidectomy for complicated forms of hemorrhoids (bleeding, nodular prolapse, mucosal prolapse, anal fissure). All patients suffered from chronic complications of stage II or III hemorrhoids, with one or more of the above complications. Selected cases are divided into three groups: Group I (control) operations on Milligan-Morgan — 240 patients, including -64 women and 176 men; Distribution by age from 18 to 75 years; Group II staple hemorrhoidopexy for Longo — 276 patients, including 89 women and 115 men. Distribution by age from 18 to 72 years; Combined interventions using the wireless Doppler surgical complex Wi-3 HAL-RAR and additional removal of excess anoderm (from January 2019 to May 2021) operated on 53 patients, including 31 (58%) men and 22 (42%) women . Distribution by age from 28 to 62 years. Results and discussion. According to our data: bed day ranged from 1 to 8 days, mostly it was lower in group III — 1.3 (± 0.4) bed per day compared to 3.1 (± 0.8) in group II and 4.8 (± 1,7) in group III resorptive fever was not observed; the highest pain syndrome for VASH (average 7 points) in the group of patients of group I — compared with patients from group II (average 4 points) and patients of group III (average 2 points); the highest number of early postoperative complications was found in the group of patients operated on Milligan- Morgan: 1) acute urinary retention was observed in 43 cases (18%) of group I, compared with 38 cases (14%) of group II. The lowest number of cases of urinary retention was observed in group III — 2 cases (4%) (p <0.05). 2) postoperative bleeding from the wound was significantly more common in group I — 9 cases (3.75%), compared with group II — 6 cases (2.5%). No postoperative bleeding was observed in group III. 3) resorptive fever was most common in group I — 43 cases (18%) compared with group II - 33 cases (12%). Resorptive fever did not occur in group III (p<0.05). In all patients using the combined intervention HAL-RAR + excision of the external component of the anoderm, the pain was acquired by taking nonspecific anti-inflammatory drugs without the use of narcotic analgesics. No complications were observed. All patients noted no reduction in quality of life in the postoperative period. Conclusions. 1. Surgical treatment of hemorrhoids by the combined method of HAL-RAR + excision of the external component is a simple and effective method that in the postoperative period reduces the patient’s stay in the hospital, relatively lower in pain and the frequency of early postoperative complications. 2. HAL-RAR technology with excision of the outer component of the anoderm can be the operation of choice in the surgical treatment of chronic complicated hemorrhoids stage II-III.

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Source of ethane in expirate of rats ventilated with 100% oxygen

Journal of Applied Physiology ◽

10.1152/jappl.1989.66.3.1268 ◽

1989 ◽

Vol 66 (3) ◽

pp. 1268-1272 ◽

Cited By ~ 7

Author(s):

M. P. Habib ◽

M. A. Katz

Keyword(s):

Group Iv ◽

Sprague Dawley ◽

Group V ◽

Group Iii ◽

Group I ◽

Free Air ◽

Sprague Dawley Rats ◽

Ethane Production ◽

Before And After ◽

Group Ii

Ethane in alveolar expirate may have its source in organs other than the lung and be transported to the lung for elimination. We determined ethane production rates in rats (group I) ventilated with hydrocarbon-free air (HFA) before and after exsanguination. To determine whether the lung is the source of increased ethane production during exposure to 100% O2, we measured ethane in the expirate of nine exsanguinated, Sprague-Dawley rats (group II) mechanically ventilated with HFA and then with 100% O2. In all nine animals, ethane elimination rates on 100% O2 increased compared with HFA values. In five of the nine rats, HFA ventilation was reinstated after O2 (group III). In all five, ethane elimination fell with HFA ventilation compared with the value on 100%. Six rats with circulation intact were ventilated with HFA and then 100% O2 (group IV). Ethane production rate for group IV animals breathing HFA was not significantly different from the exsanguinated animals in group II while ventilated with HFA. The mean increase in ethane production for the group II animals was not significantly different from the group IV animals. Lung slices from four other rats (group V) were incubated in saline at 37 degrees C with FeCl2 (10 mg) added to enhance free radical formation. Paired lung samples from the same rat were incubated with either HFA or 100% O2. Headspace gas was analyzed chromatographically for ethane at 120 min. Mean ethane in the O2 samples was higher than for HFA. Rat lung tissue is the main source of increased ethane production during 100% O2 exposure.

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Silodosin versus Tamsulosin as Medical Expulsive Therapy for Children with Lower-Third Ureteric Stones: Prospective Randomized Placebo-Controlled Study

Urologia Internationalis ◽

10.1159/000513074 ◽

2021 ◽

pp. 1-6

Author(s):

Mohamed G. Soliman ◽

Osama El-Gamal ◽

Samir El-Gamal ◽

Ali Abdel Raheem ◽

Ahmed Abou-Ramadan ◽

...

Keyword(s):

Randomized Study ◽

Study Groups ◽

Controlled Study ◽

Expulsion Rate ◽

Medical Expulsive Therapy ◽

Group Iii ◽

Group I ◽

Younger Age ◽

Significant Difference ◽

Group Ii

Aim: To compare the efficacy and safety of silodosin versus tamsulosin as medical expulsive therapy for stones of lower-third ureter in children. Patients and Methods: This prospective single-blind placebo-controlled randomized study included 167 pediatric patients who presented with distal ureteric stone (DUS) less than 1 cm. Patients were randomized into 3 groups; group I received silodosin 4 mg once daily, and group II received tamsulosin 0.4 mg while those in group III had placebo. The side effects of the used drugs, both rate and time of stone expulsion, and number of pain episodes were compared among the study groups for a maximum of 4 weeks. Results: Follow-up data of our patients after treatment revealed that the stone expulsion rate was significantly higher and the time to stone expulsion was significantly shorter in group I (89.3%, 12.4 ± 2.3 days) and group II (74.5%, 16.2 ± 4.2 days) compared to group III (51.8%, 21.2 ± 5.6). However, a statistically significant difference between silodosin and tamsulosin groups in favor of the former one was reported regarding the 2 studied items. Meanwhile, pain episodes requiring analgesia were statistically fewer in group I and II in contrast to placebo group. Adverse events were comparable among all groups. Conclusion: Silodosin provides significantly better stone expulsion rate and shorter expulsion time than tamsulosin for treatment of DUS. Both medications showed good safety profiles in children. However, further studies are required on a larger scale to confirm our results. Assessment of drug safety on younger age-group is still needed.

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Plastic for diaphragmal hernia

Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH) ◽

10.20340/vmirvz.2021.5.clin.1 ◽

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.

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Efficacy and safety of two different doses of intrathecal calcitonin, a randomized controlled study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20180320 ◽

2018 ◽

Vol 6 (2) ◽

pp. 682

Author(s):

Pravin Kumar G. ◽

Kirubahar R. ◽

Vijay Kanna M.

Keyword(s):

Adverse Events ◽

Study Groups ◽

Group Iv ◽

Control Group ◽

Efficacy And Safety ◽

Group Iii ◽

Randomized Controlled ◽

Group I ◽

Group Ii ◽

Different Doses

Background: Adjuvants play an important role in enhancing the quality of anesthesia and also in reducing the requirement of primary anesthetic and its related adverse events. Calcitonin is one such adjuvant. But there is still uncertainty regarding the appropriate dose of calcitonin to achieve maximum analgesic efficacy and safety. The current study is conducted to add to the existing evidence on the subject and was aimed to compare the efficacy and safety of two different doses of calcitonin as an adjuvant in patients undergoing spinal anesthesia.Methods: A prospective randomized controlled double-blind trial was conducted in the Department of Anesthesiology and Intensive Care, Sir Sunderlal Hospital, Banaras Hindu University from May 2006 to May 2007. A total of 80 participants aged between 18 to 60 years, with ASA I and II physical status, undergoing infra-umbilical surgeries were randomly allocated to one of the 4 intervention groups. All the 4 intervention groups received 0.5% bupivacaine (H) 3ml as a primary anesthetic agent. Group I and III received 50 IU and 100 IU salmon calcitonin as an adjuvant. Group II received placebo and group IV (control) received no adjuvant. Pinprick test, Bromage scale and 10-point Visual analog scale (VAS) were used to measure the efficacy.Results: All the study groups were comparable with respect to all baseline variables. The time interval to the first dose of analgesia was longest in 100 I.U. calcitonin group, followed by 50 I.U. calcitonin group, placebo control group. The mean duration of analgesia (in minutes) among group I (100I.U. calcitonin) was 230.00±92.39, 159.25±21.59 among group II (Placebo), 161.50±31.20 among group III (50 I.U. calcitonin) and 142.75±20.22 among group IV. Considering group IV (control group) as base line. The differences of duration of analgesia (in minutes) in group I, group II and group III with baseline value (group IV) were statistically significant (P value <0.05). Even though the proportion of subjects developing adverse events was slightly higher in 100 I.U calcitonin groups compared to other groups, they were minor adverse events and were managed appropriately. There were no significant differences across the study groups in terms of hemodynamic stability.Conclusions: Salmon calcitonin as adjuvant increases the duration of postoperative analgesia. Even though the there slightly higher incidence of adverse events with 100 I.U calcitonin they are minor and the risk-benefit ratio favors calcitonin use. To make a categorical recommendation on the appropriate dose, there is further need for large-scale studies and pooled analysis.

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Back сruroraphy and hernioplasty for diaphragm hernias of various sizes

Siberian medical review ◽

10.20333/2500136-2021-1-58-62 ◽

2021 ◽

pp. 58-62

Author(s):

I.I. Rosenfeld ◽

Keyword(s):

Plastic Surgery ◽

Study Groups ◽

Medium Size ◽

Treatment Results ◽

Hernia Defect ◽

Group Iii ◽

Group I ◽

Group Ii ◽

The One ◽

Diaphragmatic Hernias

The aim of the research. The work considers the results of posterior cruraraphy along with hernioplasty, using polypropylene and biocarbon implant in surgical treatment of diaphragmatic hernias of various sizes. Material and methods. Totally 716 patients were divided into 3 study groups, based on the size of esophageal hernia defect: group I (314 people) – with small and medium size of hiatal hernias, who underwent posterior cruraphy; group II (323 patients) – with large hernias: subgroup 1 (92 patients) underwent posterior cruraphy, subgroup 2 (231 patients) – underwent hernioplasty. Subgroup 2 was divided into: subgroup A (89 people) – plastic surgery with polypropylene implant and subgroup B (142 people) – plastic surgery with biocarbon implant. Group III (79 patients) – patients with giant hiatal hernias: subgroup A (29 people) – plastic surgery with polypropylene implant and subgroup B (50 patients) – biocarbon construction. Results. While comparing group Ӏ with group II, subgroup 1 signifi cant diff erences were found in the degrees and types of hernias. Th e age of patients was not statistically important. While comparing subgroup 1 with subgroup 2 of group II, statistically insignifi cant diff erences were revealed in degrees and types of hernias. Th e age of patients was also statistically insignifi cant. While comparing subgroup A with subgroup B of group II, insignifi cant diff erences were revealed in degrees and types of hernias. While comparing subgroup 2, group II with group III, the diff erence turned out to be signifi cant in types and degrees of hernias. While comparing subgroup A with subgroup B, group III, statistically insignifi cant diff erences were revealed in the degrees and types of hiatal hernias. Conclusion. Posterior cruraphy in small and medium diaphragmatic hernias differed in types, degrees and size of hernia defect in comparison to the one in large hernias. Posterior cruraphy with plasty for large hernias did not diff er signifi cantly according to any of the criteria. Plastic surgery by polypropylene implant with biocarbon in case of large hernias did not diff er signifi cantly by any criteria. Plastic surgery for large hernias compared to giant ones, diff ered only in the degree and types, as well as in hernia defect size. Plastic surgery by polypropylene implant with biocarbon in giant hernias did not differ in any criteria, except for gender distribution, which was not signifi cant, that made it possible to compare treatment results in these subgroups more correctly.

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