Miedema B W, Ibrahim S M, Davis B D, Koivunen D G
Department of Surgery, Harry S Truman Veterans Administration Hospital and the University of Missouri Health Center, Columbia, Missouri, USA.
Hernia. 2004 Feb;8(1):28-32. doi: 10.1007/s10029-003-0151-z. Epub 2003 Aug 1.
The main hypotheses were that the Lichtenstein inguinal hernia repair has a lower recurrence rate and similar incidence of chronic groin pain compared to sutured repairs when performed by surgical trainees. In a U.S. Veterans Administration Hospital, 150 primary hernia repairs were randomized to a Lichtenstein, McVay, or Shouldice repair. The Shouldice repair included a routine relaxing incision. First- and second-year residents, under the supervision of an experienced general surgeon, performed the procedure. Long-term follow-up was obtained in 81% of patients. Hernia recurrence rate was Lichtenstein 8%, McVay 10%, Shouldice 5% ( P>0.1) at 6-9 years follow-up. More patients had chronic groin pain following Lichtenstein repair (38%) than after Shouldice repair (7%) ( P<0.05). More information is needed on long-term groin pain following anterior mesh repair. The Shouldice inguinal hernia repair may have a role in open primary herniorrhaphy to decrease the risk of chronic groin pain.
主要假设为，对于外科住院医师实施的腹股沟疝修补术，与缝合修补术相比，Lichtenstein腹股沟疝修补术的复发率更低，慢性腹股沟疼痛的发生率相似。在美国一家退伍军人管理局医院，150例原发性疝修补术被随机分为Lichtenstein修补术、McVay修补术或Shouldice修补术。Shouldice修补术包括常规的松弛切口。在一名经验丰富的普通外科医生的监督下，第一年和第二年的住院医师实施该手术。81%的患者获得了长期随访。在6至9年的随访中，Lichtenstein修补术的疝复发率为8%，McVay修补术为10%，Shouldice修补术为5%（P>0.1）。Lichtenstein修补术后出现慢性腹股沟疼痛的患者（38%）多于Shouldice修补术后（7%）（P<0.05）。对于前路补片修补术后的长期腹股沟疼痛，还需要更多信息。Shouldice腹股沟疝修补术在开放性原发性疝修补术中可能有助于降低慢性腹股沟疼痛的风险。
