Avtor/Urednik		Krebs, Bojan; Novak, Marko; Vidovič, Damijan; Ivanecz, Arpad
Naslov		Operacije dimeljske kile v letih 2000 in 2001 ter primerjava z letoma 1996 in 1997 na Oddelku za abdominalno kirurgijo Učne bolnišnice Maribor
Prevedeni naslov		Inguinal hernia surgery at Department of abdominal surgery, General hospital Maribor in the years 2000 and 2001 and comparison with the years 1996 and 1997
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 72, št. Suppl 1
Leto izdaje		2003
Obseg		str. I-13-5
Jezik		slo
Abstrakt		Background. Inguinal hernia repair is one of the most common surgical procedure sperformed in the world and as that represents a huge socio-economicproblem. Today, surgeon can significantly improve outcome for many patients with proper patients selection, proper anaesthesia and surgical technique. In this article two different time intervals are reviewed. Between those intervals surgeons began to change their attitudes about hernia surgery approach and "tensionfree" concept became widely accepted. We also operated many patients under local anaesthesia, which has many advantages between which is lesser need for preoperative investigations and faster mobilisation. Methods. In article charts from all patients operated for inguinal hernia in years 1996 1997, 2000 and 2001 at the Department for abdominal surgery in Maribor. Results. 1602 patients were operated for inguinal hernia in four years. We noticed that less patients were operated in years 2000/2001 then in the earlier interval Number of the patients operated under general anaesthesia was relatively high in first period but in the second interval majority of the patients were operated under subarachnoidal and local anaesthesia. While most patients in years 1996 and 1997 were operated with original Bassini's technique and its modifications, majority of patients in years 2000 and 2001 were treated with tension free technique. Conclusions. Our experiences with tension free techniques are verygood. There are many advantages for patients, operated this way: less pooperative pain, faster recovery and earlier return to normal activities and work. We couldn't prove any benefits considering recurrences in our study yet, probably because of two short observation period.
Izvleček		Izhodišča. Operacija dime jskih kil je ena najpogostejših operacij v splošni kirurgiji. S svojim obsegom predstavlja veliko obremenitev za zdravstvo. Kirurg lahko s svojim izborom bolnika in izborom ustrezne anestezije ter tehnike pomembno vpliva na stroške operacije in rehabilitacijo. V članku sta obdelani in primerjani dve različni obdobji, med katerima je prišlo do ključne spremembe kirurške tehnike, ki vodi do boljših rezultatov na področju kirurgije dimeljskih kil. Posebej velja opozoriti na visok delež bolnikov, ki so bili operirani v lokalni anesteziji, kar omogoča hitrejšo mobilizacijo bolnika ter prispeva h hitrejši rehabilitaciji. Metode. Pregledali smo popise vseh bolnikov, ki so bili v letih 1996 1997, 2000 in 2001 operirani zaradi dimeljskih kil na Oddelku za abdominalno kirurgijo Učne bolnišnice Maribor Rezultati. V obdelanih štirih letih sta bila operirana 1602 bolnikov. Opazili smo upadanje števila operacij dime jskih kil. V prvem obdobju je bilo veliko bolnikov operiranih v splošni anesteziji, v letih 2000 in 2001 pa je to število padlo predvsem na račun operacij, ki so bile naprav jene v lokalni anesteziji. Z uvedbo nenapetostnih tehnik v svetu smo to metodo osvojili tudi pri nas in v drugem obdobju večino bolnikov operirali že z njeno pomočjo. Stevilo ponovitev za enkrat ostaja na približno enaki ravni. Zaključki. Naše izkušnje z nenapetostnimi tehnikami so dobre. Prednosti za bolnika so predvsem manjša pooperativna bolečina, hitrejše okrevanje in zgodnja vrnitev na delo terdokaj znižana možnost ponovitve. Zaenkrat v našem prispevku še nismo mogli dokazati manj recidivov po nenapetostnih operacijah, ker je čas opazovanja {e prekratek. Vendar pa se bo razlika gotovo pokazala kmalu.
Deskriptorji		HERNIA, INGUINAL ANESTHESIA, GENERAL ANESTHESIA, SPINAL ANESTHESIA, LOCAL TIME FACTORS