Bay-Nielsen M, Nordin P, Nilsson E, Kehlet H
Department of Surgical Gastroenterology, Hvidovre University Hospital, Hvidovre, Denmark.
Am J Surg. 2001 Aug;182(2):134-6. doi: 10.1016/s0002-9610(01)00674-2.
Recurrence after inguinal herniorraphy continues to be a problem, although the Lichtenstein technique (anterior, open fixated sheet mesh) is associated with reduced recurrence rates. Recurrence after Lichtenstein repair is suspected to be caused by insufficient fixation and overlap at the pubic tubercle.
A review was made of 87 records from operations for recurrence after a previous Lichtenstein procedure, based upon national and large area data bases, recording 95% (Denmark) and 50% (Sweden) of all inguinal hernia operations.
Direct recurrences were found in 62%, whereas the remaining recurrences were either indirect (17%), femoral (13%), or other/unclassified (8%).
The most plausible explanation for the development of the direct recurrences is an insufficient medial mesh fixation and overlap over the pubic tubercle. Avoidance of more than half of the recurrences after the Lichtenstein repair may be obtained by increased attention to this specific technical aspect of the operation.
尽管利希滕斯坦技术（前路开放式固定补片修补术）可降低复发率，但腹股沟疝修补术后复发仍是一个问题。利希滕斯坦修补术后的复发被怀疑是由于耻骨结节处固定不充分和补片重叠不足所致。
基于国家和大面积数据库，对87例既往利希滕斯坦手术术后复发的手术记录进行回顾，这些数据库记录了所有腹股沟疝手术的95%（丹麦）和50%（瑞典）。
62%为直疝复发，其余复发类型为斜疝（17%）、股疝（13%）或其他/未分类（8%）。
直疝复发最合理的解释是补片在内侧固定不充分以及在耻骨结节上重叠不足。通过更多关注手术的这一特定技术方面，可避免利希滕斯坦修补术后超过一半的复发。
