[Principles of surgical treatment of inguinal hernia]

The work is based on the analysis of the results of surgical treatment of inguinal hernias in 198 patients in the period from 1983 to 1988. Most of the patients were over 60 years of age, a lesser number were under 35 (11.1%). Hernias of a complicated and transitional form were found in 174 patients and mild forms only in 24 patients. The hernias were recurrent in 45 and sliding in 59 patients. Proceeding from the specific features of the surgical anatomy of the inguinal space, all patients, irrespective of their age and the form and type of the hernia, were treated by operation with plastics of the opening of the hernial sac to the back of the elements of the spermatic cord. The only exception were patients under 35 years of age with a mild form of oblique inguinal hernia, in which case variants of operations with enforcement of the anterior wall of the inguinal canal were carried out. The Schouldies and McVay methods were preferred, in recurrent and all complicated forms of inguinal hernias they were combined with operations of the Endrews and Postempsky types; the last named was mostly used in individuals over 60 years of age and in repeatedly recurring hernias. The late-term results were studied in follow-up periods of 2 to 7 years in 176 patients in the group of 198 individuals who were operated on. In 77.7% of them 3-6 years have passed since the operation. Almost all patients of mature age have resumed their occupation, there are complaints neither of pain at the site of the operation nor of changes in sexual potency. Recurrent hernias were not detected.