14 research outputs found
Surgical Treatment of Inguinal Canal Hernias in Boys: an Analysis of Five Yearsβ Experience
Introduction. Currently the surgical treatment of inguinal hernias in children is usually a high ligation of the hernia sac without the separation of its distal portion or plastic reconstruction of the inguinal canal. This technique is considered the treatment of choice as it has brought down the incidence of post-operative hernias and testicular atrophy. However, the issues of approach to the selection of a conservative treatment strategy and the role played by instrumental examination methods used to determine indications for surgical treatment remain controversial.Materials and methods. This paper presents a retrospective analysis of 684 clinical cases followed up at the Yaroslavl Regional Childrenβs Teaching Hospital. The study included boys aged one month to 17 years who were treated for inguinal and inguinoscrotal hernias in 2011-2015.Results and discussion. 89 patients (10.3%) were hospitalised with incarcerated inguinal and inguinoscrotal hernias in the period under review. Of these, in 86 patients, when the incarceration lasted under 12 hours, conservative treatment attempts were undertaken. Hernia reduction was achieved without any direct manipulation on the hernia sac in 10 boys (11.6%). Attempts of manual hernia reduction were undertaken in the remaining 56 children (65.1%); these resulted in successful outcomes in 47 patients (83.9%). Emergency surgical repair of incarcerated hernias was performed in 23 cases (3.1%). No patients with incarcerated hernias were older than seven years. 45 out of 183 boys (29.5%) had scrotal oedemas and haematomas in the early post-operative period following planned hernia repair surgeries.Conclusion.Β In the majority of patients hospitalised early the conservative hernia reduction approach was effective and resulted in fewer emergency hernia repair surgeries. Ultrasound examination of inguinal canal may be considered as a method of screening for asymptomatic hernias
Π₯ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ ΠΌΠ°Π»ΡΡΠΈΠΊΠΎΠ² Ρ Π³ΡΡΠΆΠ°ΠΌΠΈ ΠΏΠ°Ρ ΠΎΠ²ΠΎΠ³ΠΎ ΠΊΠ°Π½Π°Π»Π°. ΠΠ½Π°Π»ΠΈΠ· ΠΏΡΡΠΈΠ»Π΅ΡΠ½Π΅Π³ΠΎ ΠΎΠΏΡΡΠ°
Introduction. Currently the surgical treatment of inguinal hernias in children is usually a high ligation of the hernia sac without the separation of its distal portion or plastic reconstruction of the inguinal canal. This technique is considered the treatment of choice as it has brought down the incidence of post-operative hernias and testicular atrophy. However, the issues of approach to the selection of a conservative treatment strategy and the role played by instrumental examination methods used to determine indications for surgical treatment remain controversial.Materials and methods. This paper presents a retrospective analysis of 684 clinical cases followed up at the Yaroslavl Regional Childrenβs Teaching Hospital. The study included boys aged one month to 17 years who were treated for inguinal and inguinoscrotal hernias in 2011-2015.Results and discussion. 89 patients (10.3%) were hospitalised with incarcerated inguinal and inguinoscrotal hernias in the period under review. Of these, in 86 patients, when the incarceration lasted under 12 hours, conservative treatment attempts were undertaken. Hernia reduction was achieved without any direct manipulation on the hernia sac in 10 boys (11.6%). Attempts of manual hernia reduction were undertaken in the remaining 56 children (65.1%); these resulted in successful outcomes in 47 patients (83.9%). Emergency surgical repair of incarcerated hernias was performed in 23 cases (3.1%). No patients with incarcerated hernias were older than seven years. 45 out of 183 boys (29.5%) had scrotal oedemas and haematomas in the early post-operative period following planned hernia repair surgeries.Conclusion.Β In the majority of patients hospitalised early the conservative hernia reduction approach was effective and resulted in fewer emergency hernia repair surgeries. Ultrasound examination of inguinal canal may be considered as a method of screening for asymptomatic hernias.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. Π₯ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ ΠΏΠ°Ρ
ΠΎΠ²ΡΡ
Π³ΡΡΠΆ Ρ Π΄Π΅ΡΠ΅ΠΉ Π½Π° ΡΠ΅Π³ΠΎΠ΄Π½ΡΡΠ½ΠΈΠΉ Π΄Π΅Π½Ρ Π·Π°ΠΊΠ»ΡΡΠ°Π΅ΡΡΡ Π² Π²ΡΡΠΎΠΊΠΎΠΉ ΠΏΠ΅ΡΠ΅Π²ΡΠ·ΠΊΠ΅ Π³ΡΡΠΆΠ΅Π²ΠΎΠ³ΠΎ ΠΌΠ΅ΡΠΊΠ° Π±Π΅Π· Π²ΡΠ΄Π΅Π»Π΅Π½ΠΈΡ Π΄ΠΈΡΡΠ°Π»ΡΠ½ΠΎΠΉ Π΅Π³ΠΎ ΡΠ°ΡΡΠΈ ΠΈ Π±Π΅Π· ΠΏΠ»Π°ΡΡΠΈΠΊΠΈ ΠΏΠ°Ρ
ΠΎΠ²ΠΎΠ³ΠΎ ΠΊΠ°Π½Π°Π»Π°. ΠΠΈΠ·ΠΊΠ°Ρ ΡΠ°ΡΡΠΎΡΠ° ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΡ
ΡΠ΅ΡΠΈΠ΄ΠΈΠ²ΠΎΠ² Π³ΡΡΠΆ ΠΈ Π°ΡΡΠΎΡΠΈΠΉ ΡΠΈΡΠΊΠ° Π΄Π°Π»Π° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΡΠΈΡΠ°ΡΡ Π΄Π°Π½Π½ΡΡ ΡΠ΅Ρ
Π½ΠΈΠΊΡ Π³ΡΡΠΆΠ΅ΡΠ΅ΡΠ΅Π½ΠΈΠΉ ΠΎΠΏΡΠΈΠΌΠ°Π»ΡΠ½ΠΎΠΉ. ΠΠ΄Π½Π°ΠΊΠΎ Π½Π΅ΠΎΠ΄Π½ΠΎΠ·Π½Π°ΡΠ½ΡΠΌΠΈ ΠΎΡΡΠ°ΡΡΡΡ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Ρ ΠΊ Π²ΡΠ±ΠΎΡΡ ΡΠ°ΠΊΡΠΈΠΊΠΈ ΠΊΠΎΠ½ΡΠ΅ΡΠ²Π°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΈ ΡΠΎΠ»ΠΈ ΠΈΠ½ΡΡΡΡΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΏΡΠΈ Π²ΡΡΡΠ°Π²Π»Π΅Π½ΠΈΠΈ ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΠΉ ΠΊ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ.Β ΠΠ° Π±Π°Π·Π΅ ΠΠ±Π»Π°ΡΡΠ½ΠΎΠΉ Π΄Π΅ΡΡΠΊΠΎΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»ΡΠ½ΠΈΡΡ (Π³. Π―ΡΠΎΡΠ»Π°Π²Π»Ρ) ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ ΡΠ΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· 684 ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠΉ Π·Π° ΠΌΠ°Π»ΡΡΠΈΠΊΠ°ΠΌΠΈ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ ΠΎΡ 1 ΠΌΠ΅ΡΡΡΠ° Π΄ΠΎ 17 Π»Π΅Ρ, ΠΎΠ±ΡΠ°ΡΠΈΠ²ΡΠΈΡ
ΡΡ Ρ ΠΏΠ°Ρ
ΠΎΠ²ΡΠΌΠΈ ΠΈ ΠΏΠ°Ρ
ΠΎΠ²ΠΎ-ΠΌΠΎΡΠΎΠ½ΠΎΡΠ½ΡΠΌΠΈ Π³ΡΡΠΆΠ°ΠΌΠΈ Π² ΠΏΠ΅ΡΠΈΠΎΠ΄ Ρ 2011 ΠΏΠΎ 2015 Π³ΠΎΠ΄.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈ ΠΎΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅.Β ΠΠ° ΠΏΠ΅ΡΠΈΠΎΠ΄ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π±ΡΠ»ΠΎ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½ΠΎ 89 (10,3 %) ΠΌΠ°Π»ΡΡΠΈΠΊΠΎΠ² Ρ ΡΡΠ΅ΠΌΠ»Π΅Π½ΠΈΠ΅ΠΌ ΠΏΠ°Ρ
ΠΎΠ²ΡΡ
ΠΈ ΠΏΠ°Ρ
ΠΎΠ²ΠΎ-ΠΌΠΎΡΠΎΠ½ΠΎΡΠ½ΡΡ
Π³ΡΡΠΆ. Π£ 86 ΠΈΠ· Π½ΠΈΡ
Ρ ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡΡ ΡΠΈΠΌΠΏΡΠΎΠΌΠΎΠ² ΡΡΠ΅ΠΌΠ»Π΅Π½ΠΈΡ Π΄ΠΎ 12 ΡΠ°ΡΠΎΠ² Π±ΡΠ»ΠΈ ΠΏΡΠ΅Π΄ΠΏΡΠΈΠ½ΡΡΡ ΠΏΠΎΠΏΡΡΠΊΠΈ ΠΊΠΎΠ½ΡΠ΅ΡΠ²Π°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π²ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΡ Π³ΡΡΠΆ. ΠΠΏΡΠ°Π²Π»Π΅Π½ΠΈΠ΅ ΠΏΡΠΎΠΈΠ·ΠΎΡΠ»ΠΎ Ρ 10 (11,6 %) ΠΌΠ°Π»ΡΡΠΈΠΊΠΎΠ² Π±Π΅Π· ΠΏΡΡΠΌΠΎΠ³ΠΎ Π²ΠΎΠ·Π΄Π΅ΠΉΡΡΠ²ΠΈΡ Π½Π° Π³ΡΡΠΆΠ΅Π²ΠΎΠ΅ Π²ΡΠΏΡΡΠΈΠ²Π°Π½ΠΈΠ΅. ΠΡΡΠ°Π»ΡΠ½ΡΠΌ 56 (65,1 %) Π΄Π΅ΡΡΠΌ Π±ΡΠ»ΠΎ ΠΏΡΠ΅Π΄ΠΏΡΠΈΠ½ΡΡΠΎ ΠΌΠ°Π½ΡΠ°Π»ΡΠ½ΠΎΠ΅ Π²ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΠ΅ Π³ΡΡΠΆ, ΠΊΠΎΡΠΎΡΠΎΠ΅ ΠΎΠΊΠ°Π·Π°Π»ΠΎΡΡ ΡΡΠΏΠ΅ΡΠ½ΡΠΌ Ρ 47 (83,9 %) ΠΈΠ· Π½ΠΈΡ
. ΠΠΊΡΡΡΠ΅Π½Π½ΠΎΠ΅ Π³ΡΡΠΆΠ΅ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ ΠΏΠΎ ΠΏΠΎΠ²ΠΎΠ΄Ρ ΡΡΠ΅ΠΌΠ»Π΅Π½ΠΈΡ Π³ΡΡΠΆ ΠΏΠΎΡΡΠ΅Π±ΠΎΠ²Π°Π»ΠΎΡΡ Π² 23 Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡΡ
(3,1 %). ΠΠ΅ΡΠΈ ΡΡΠ°ΡΡΠ΅ 7 Π»Π΅Ρ Ρ ΡΡΠ΅ΠΌΠ»Π΅Π½Π½ΡΠΌΠΈ Π³ΡΡΠΆΠ°ΠΌΠΈ Π½Π΅ Π²ΡΡΡΠ΅ΡΠ°Π»ΠΈΡΡ. ΠΠ»Π°Π½ΠΎΠ²ΡΠ΅ Π³ΡΡΠΆΠ΅ΡΠ΅ΡΠ΅Π½ΠΈΡ Ρ 54 ΠΈΠ· 183 ΠΌΠ°Π»ΡΡΠΈΠΊΠΎΠ² (29,5 %) ΡΠΎΠΏΡΠΎΠ²ΠΎΠΆΠ΄Π°Π»ΠΈΡΡ ΠΎΡΠ΅ΠΊΠ°ΠΌΠΈ ΠΈ Π³Π΅ΠΌΠ°ΡΠΎΠΌΠ°ΠΌΠΈ ΠΌΠΎΡΠΎΠ½ΠΊΠΈ Π² ΡΠ°Π½Π½Π΅ΠΌ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ΅ΡΠΎΠ΄ ΠΊΠΎΠ½ΡΠ΅ΡΠ²Π°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π²ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΡ ΡΡΠ΅ΠΌΠ»Π΅Π½Π½ΡΡ
Π³ΡΡΠΆ ΠΎΠΊΠ°Π·Π°Π»ΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΡΠΌ Ρ Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΏΡΠΈ ΡΠ°Π½Π½Π΅ΠΌ ΠΎΠ±ΡΠ°ΡΠ΅Π½ΠΈΠΈ Π² ΡΡΠ°ΡΠΈΠΎΠ½Π°Ρ ΠΈ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ» ΡΠ½ΠΈΠ·ΠΈΡΡ ΡΠ°ΡΡΠΎΡΡ ΡΠΊΡΡΡΠ΅Π½Π½ΡΡ
Π³ΡΡΠΆΠ΅ΡΠ΅ΡΠ΅Π½ΠΈΠΉ. Π ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΠ°Ρ
ΠΎΠ²ΡΡ
ΠΊΠ°Π½Π°Π»ΠΎΠ² Ρ ΠΌΠ°Π»ΡΡΠΈΠΊΠΎΠ² ΠΌΠΎΠΆΠ΅Ρ ΡΠ»ΡΠΆΠΈΡΡ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΡΠΊΡΠΈΠ½ΠΈΠ½Π³Π° Π°ΡΠΈΠΌΠΏΡΠΎΠΌΠ½ΡΡ
Π³ΡΡΠΆ