Prudnikov A. The choice of surgical treatment of inguinal hernia in elderly and senile patients

Surgical treatment of inguinal hernia was performed in 220 elderly and senile patients. The 103 patients were performed non-tension methods. Other 117 were performed tension plastic methods. It was established that in elderly and senile patients there are involutive processes in the structural components of the walls of the inguinal canal. It is noted that the biomechanical instability of connective tissue structures in patients of this age group plays an important role in the formation of oblique inguinal hernia. Significant inhibition of growth of different types of muscular fibers result in decreased elastic capacity and speed of their contractile response that is the pathogenic factor in the formation of direct inguinal hernia. A modification of Lichtenstein technique, which is appropriate to perform in patients of elderly age group, was suggested. The technique of surgical intervention in patients with inguinal hernia of the IVth-type by Nyhus after the performance of hernioplasty by Lichtenstein, was worked out. Algorithm of the operative method selection in inguinal hernia in elderly and senile patients, adherence of which in a general in-patient surgical hospital conditions helps to achieve a shorter period of hospitalization, more rapid physical rehabilitation of patients, a lower number of complications and recurrences, was also worked out.