LONG-TERM RESULTS EVALUATION OF SURGICAL TREATMENT OF STRANGULATED INGUINAL HERNIA. ANALYSIS OF OPEN AND LAPAROSCOPIC METHODS

Abstract

The aim of the study was to evaluate the effect of individual correction of the immune system on the longterm results of surgical treatment of strangulated inguinal hernia using open and laparoscopic methods. The study included 85 patients with strangulated inguinal hernia, who were divided into two groups: the main group of 45 people who underwent laparoscopic hernioplasty - TAPP (МG) and comparison of 40 people who underwent surgery using the Lichtenstein method (СG). The studies were conducted 6-8 months after the surgery. After the surgery, patients were given recommendations for individual correction of their immune status. The total number of T- and B-lymphocytes, T-lymphocyte subpopulations: CD3, CD19, CD4, CD8, CD16, and changes in the content of immunoglobulin classes: IgA, IgM, IgG in the blood serum were studied. An integral determination of the quality of life was also performed using the SF-36 method. In the CG patients, the CD3+ indices were reduced compared to the control indices (41.16±1.9%), and were also significantly lower than in the group of patients operated on using the TAPP method (51.07±1.8). The Tx/Ts index was significantly reduced in the CG (1.28±0.07). The values of the complex index of the physical component of health in the CG were 46.68±4.25 points and were lower by 5.50% (p<0.05) compared to the MG patients = 52.18±5.96 points. The pain intensity values in the CG were lower by 13.88% (p<0.005) compared to the MG patients. Patients in both groups had no re-hospitalizations within 12 months after surgery, which indicates a significant positive impact of a comprehensive individual approach to patient care in the postoperative period.