Back сruroraphy and hernioplasty for diaphragm hernias of various sizes

I. Rosenfeld
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Abstract

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.
不同大小膈疝的背部造影及疝成形术
研究的目的。这项工作考虑了后颅摄影和疝成形术的结果,使用聚丙烯和生物碳植入物在手术治疗不同大小的膈疝。材料和方法。716例患者根据食道疝缺损的大小分为3个研究组:I组(314人)-中小型食道疝,行后路造影;II组(323例)-大疝:亚组1(92例)行后路造影,亚组2(231例)行疝成形术。第二组分为A组(89人)和B组(142人),分别为聚丙烯植入体和生物碳植入体。III组(79例)-巨大裂孔疝患者:A亚组(29例)-聚丙烯植入物整形手术;B亚组(50例)-生物碳结构。结果。而Ӏ组与II组比较,亚组1在疝的程度和类型上有显著差异。患者的年龄在统计学上不重要。II组1亚组与2亚组比较,在疝的程度和类型上差异无统计学意义。患者年龄差异无统计学意义。II组A亚组与B亚组比较,在疝的程度和类型上差异无统计学意义。2亚组、II组与III组比较,在疝类型和程度上差异有统计学意义。A亚组与B亚组、III组比较,裂孔疝发生程度、类型差异无统计学意义。结论。与大膈疝相比,小膈疝和中膈疝的后路造影在疝缺损的类型、程度和大小上存在差异。根据任何标准,大疝成形术的后路造影没有显着差异。在大疝的情况下,聚丙烯植入物与生物碳的整形手术在任何标准下都没有显著差异。大疝的整形手术与大疝相比,只是在程度和类型以及疝缺损大小上有所不同。聚丙烯植入生物碳在巨大疝中的整形手术在任何标准上都没有差异,除了性别分布,这是不显著的,这使得可以更正确地比较这些亚组的治疗结果。
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