Zollinger Robert M
University Hospitals of Cleveland, Case Western Reserve University, School of Medicine, Cleveland, OH 44106, USA.
Surg Clin North Am. 2003 Oct;83(5):1053-63. doi: 10.1016/S0039-6109(03)00126-9.
All groin hernia classifications are somewhat arbitrary and artificial. Currently, there is no consensus among either general surgeons or hernia specialists as to a preferred system. A survey by Zollinger in 1998 of hernia specialists in North American and Europe showed, that although the Nyhus, Gilbert, and Schumpelick-Arit systems were commonly used, the majority of these specialists still used the traditional classification for groin hernias. It is apparent that only the traditional classification of groin hernias has stood the test of time. As stated by Fitzgibbons, "the primary purpose of a classification system for any disease is to stratify for severity so that reasonable comparisons can be made between various treatment strategies." Given the multiplicity of operative techniques and approaches for the repair of groin hernias, it appears that no one classification system can satisfy all. With time, it is likely that we surgeons will settle upon a given operation for a specific type of inguinal hernia. For that given operation to be accepted as proven best, however, it is essential the competing operations be applied to simliar (classified) groups of groin hernia patients.
所有腹股沟疝的分类都多少有些随意和人为设定。目前，普通外科医生或疝外科专家对于哪种分类系统更为合适尚未达成共识。1998年佐林格对北美和欧洲的疝外科专家进行的一项调查显示，尽管纽黑文（Nyhus）、吉尔伯特（Gilbert）和舒姆佩利克 - 阿里特（Schumpelick - Arit）系统被广泛使用，但这些专家中的大多数仍采用腹股沟疝的传统分类方法。显然，只有腹股沟疝的传统分类经受住了时间的考验。正如菲茨吉本斯（Fitzgibbons）所说：“任何疾病分类系统的主要目的都是根据严重程度进行分层，以便能够对各种治疗策略进行合理比较。”鉴于腹股沟疝修补手术技术和方法的多样性，似乎没有一种分类系统能满足所有需求。随着时间的推移，我们外科医生很可能会针对特定类型的腹股沟疝确定一种特定的手术方式。然而，要使这种特定的手术被公认为最佳手术方式，至关重要的是，与之竞争的手术应应用于类似（分类）的腹股沟疝患者群体。
