Ichioka Kentaro, Yoshimura Koji, Utsunomiya Noriaki, Ueda Nobufumi, Matsui Yoshiyuki, Terai Akito, Arai Yoichi
Department of Urology, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.
Urology. 2004 Feb;63(2):278-81. doi: 10.1016/j.urology.2003.09.038.
To assess the incidence of, and risk factors for, inguinal hernia after retropubic radical prostatectomy compared with after pelvic lymph node dissection and total cystectomy.
A total of 155 radical prostatectomies, 35 pelvic lymph node dissections, and 56 total cystectomies were included in this study. We reviewed the charts retrospectively and evaluated the incidence of, and risk factors for, inguinal hernia after surgery using Kaplan-Meier plots and a Cox proportional hazard model.
Of 155 patients in the radical prostatectomy group, 35 patients in the pelvic lymph node dissection group, and 56 patients in the cystectomy group, 33 (21.3%), 4 (11.4%), and 3 (5.4%), respectively, developed inguinal hernias during follow-up. In the radical prostatectomy group, 27 (81.8%) of the 33 patients developed inguinal hernia within 2 years postoperatively. Multivariate Cox proportional hazard analysis revealed that prostatectomy group, past history of inguinal hernia, and body mass index of less than 23 were significant risk factors for postoperative inguinal hernia.
The incidence of inguinal hernia after radical prostatectomy is not low. Urologists should realize that inguinal hernia is one of the major complications of radical prostatectomy and examine the groin preoperatively and postoperatively.
评估耻骨后根治性前列腺切除术后腹股沟疝的发生率及危险因素,并与盆腔淋巴结清扫术和全膀胱切除术后进行比较。
本研究纳入了155例根治性前列腺切除术、35例盆腔淋巴结清扫术和56例全膀胱切除术。我们回顾性查阅病历,并使用Kaplan-Meier曲线和Cox比例风险模型评估术后腹股沟疝的发生率及危险因素。
在根治性前列腺切除术组的155例患者、盆腔淋巴结清扫术组的35例患者和膀胱切除术组的56例患者中,分别有33例(21.3%)、4例(11.4%)和3例(5.4%)在随访期间发生腹股沟疝。在根治性前列腺切除术组中,33例患者中有27例(81.8%)在术后2年内发生腹股沟疝。多因素Cox比例风险分析显示,前列腺切除术组、既往腹股沟疝病史和体重指数小于23是术后腹股沟疝的显著危险因素。
根治性前列腺切除术后腹股沟疝的发生率不低。泌尿外科医生应认识到腹股沟疝是根治性前列腺切除术的主要并发症之一,并在术前和术后检查腹股沟区。