Optimization of treatment of patients with inguinal hernia in combination with recurrence of varicose veins

V. E. Milyukov, A. Chernookov, S. Kandyba, N. O. Bartosh, O. M. Dondup, А. A. Atayan, A. A. Ramazanov, A. Z. Pshmakhova, T. I. Shadyzheva
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Abstract

Introduction. In recent years, surgeons have increasingly used combined operations in patients with inguinal hernias and recurrent varicose veins. However, it is necessary to justify the choice of the type and volume of the main and concomitant stages of combined surgery, depending on the individual characteristics of both diseases.Aim. Optimization of surgical treatment of patients with inguinal hernias in combination with relapses of varicose veins.Materials and methods. The study included 39 patients aged 35 to 78 years with inguinal hernias and RVB. Of these, 21 patients who underwent combined operations were included in the main group. The control group included 18 patients who underwent staged hernioplasty, and then after 1–26 months, operations for RVB, or interventions were performed in reverse order. A comparative assessment of the duration of operations, the level of postoperative pain, immediate and long-term results, and the number of complications of uncorrected diseases in two-stage treatment was carried out.Results and discussion. Performing combined operations in this category of patients does not lead to an increase in the level of postoperative complications, it is accompanied by an average increase in the duration of surgery by 33.6 minutes and an increase in the intensity of postoperative pain by 0.8 points, a decrease in temporary disability by 1.2 times.Conclusions. Performing combined operations is the optimal intervention in patients with inguinal hernias with concomitant recurrence of varicose veins. The use of combined operations makes it possible to simultaneously eliminate both diseases and exclude the development of complications from an uncorrected disease, which, with two-stage treatment, was observed in 11.1% of cases and required emergency operations.
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腹股沟疝合并静脉曲张复发患者的最佳治疗方法
简介近年来,外科医生越来越多地对腹股沟疝和复发性静脉曲张患者采用联合手术。然而,有必要根据两种疾病的个体特征,合理选择联合手术主要阶段和伴随阶段的类型和手术量。优化腹股沟疝合并静脉曲张复发患者的手术治疗。研究纳入了 39 名腹股沟疝合并 RVB 患者,年龄在 35 岁至 78 岁之间。其中,21 名接受联合手术的患者被纳入主组。对照组包括 18 名患者,他们接受了分期疝成形术,然后在 1-26 个月后接受 RVB 手术,或以相反的顺序进行干预。对两阶段治疗的手术时间、术后疼痛程度、近期和远期效果以及未纠正疾病的并发症数量进行了比较评估。对这类患者实施联合手术不会导致术后并发症的增加,但手术时间平均增加了 33.6 分钟,术后疼痛强度增加了 0.8 点,暂时性残疾减少了 1.2 倍。对于腹股沟疝同时伴有静脉曲张复发的患者,实施联合手术是最佳干预措施。采用联合手术可同时消除两种疾病,并排除未纠正疾病引起的并发症,在采用两阶段治疗的病例中,有11.1%的患者需要进行紧急手术。
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