The importance of ultrasonography during surgical treatment of inguinal hernia repair

Relevance. Inguinal hernia ranks first in the overall structure of pathology. The technique of surgical treatment of inguinal hernia by anterior and posterior approaches has been developed in detail. However, complications are possible with all surgical methods. Ultrasound allows us to determine the features of the anatomical structure of the inguinal region and identify complications after surgery when they develop, but the results of such studies are not yet sufficiently presented in the literature.

Objective: to evaluate the role of ultrasound for diagnosing inguinal hernia in men and women, assessing the condition of tissues in the inguinal regions and detecting complications after various surgical methods.

Object and methods. The analysis of treatment of 242 patients with inguinal hernia aged from 21 to 92 years was conducted. There were 217 men (89.7%), 25 women (10.3%). In addition to collecting clinical data, all patients underwent ultrasound of the inguinal regions before and after surgery. Additionally, using ultrasound, age-related changes in the tissues of the inguinal regions were studied in 50 patients aged 60-70 years without hernias. There were 43 men (86%), 17 women (14%). All operations were performed by the anterior combined method using mesh implants. Patients were divided into 2 groups. In group 1 (main), the operation was completed with wound drainage, in group 2 (comparison), wound drainage was not performed. Interventions were assessed by the nature and number of complications.

Results. It was found that according to ultrasound data in patients with and without hernias, the thickness of the subcutaneous tissue, the total thickness of the muscles and aponeurosis did not differ. The frequency of complications was affected by wound drainage at the final stage of the intervention. This made it possible to reduce the frequency of seromas by 3.9 times, hematomas - by 4.3 times, suppurations - by 4.3 times in group 1 compared to group 2 (p < 0.001).

Conclusions. In patients with inguinal hernia, ultrasound allows confirming the diagnosis, assessing the condition of tissues in the groin area, identifying wound complications and eliminating them at an early stage. In patients with inguinal hernia, when performing anterior prosthetic methods of plastic surgery, it is necessary to complete the operation with wound drainage, which improves immediate and remote treatment results. Logistic regression of complication predictors showed that the frequency of complications was statistically significantly higher in patients with unilateral right-sided hernias compared to left-sided inguinal hernias.

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