Takagi H, Sugimoto M, Kato T, Matsuno Y, Umemoto T
Department of Cardiovascular Surgery, Shizuoka Medical Centre, Shizuoka, Japan.
Eur J Vasc Endovasc Surg. 2007 Feb;33(2):177-81. doi: 10.1016/j.ejvs.2006.07.009. Epub 2006 Aug 23.
We conducted a systematic review to determine the incidence of postoperative incision hernia in patients with abdominal aortic aneurysm compared to those with aortoiliac occlusive disease.
Studies which compared the incidence of postoperative incision hernia in patients with abdominal aortic aneurysm and aortoiliac occlusive disease undergoing midline incision for arterial reconstruction were identified. MEDLINE was searched for articles published between January 1966 and September 2005.
Our search identified seven studies including data on 1132 patients, 719 with abdominal aortic aneurysm and 413 with aortoiliac occlusive disease. Pooled analysis demonstrated that patients with abdominal aortic aneurysm had a 2.9-fold increased risk of inguinal hernia (odds ratio 2.85, 95% confidence interval 1.71-4.77, p<0.0001), and a 2.8-fold risk of incisional hernia (2.79, 1.88-4.13, p<0.0001). Adjusting for other known risk factors patients with aortic aneurysm had a 5-fold increased risk of incisional hernia (5.45, 2.48-11.94, p<0.0001).
Patients with abdominal aortic aneurysm appear to have an approximately 3-fold increased risk for both inguinal and postoperative incision hernia compared to patients with aortoiliac occlusive disease. A large multi-centre prospective study is needed to confirm the results of this review.
我们进行了一项系统评价，以确定腹主动脉瘤患者与主髂动脉闭塞性疾病患者术后切口疝的发生率。
检索比较腹主动脉瘤患者和主髂动脉闭塞性疾病患者接受中线切口动脉重建术后切口疝发生率的研究。检索MEDLINE数据库中1966年1月至2005年9月发表的文章。
我们的检索确定了7项研究，包括1132例患者的数据，其中719例为腹主动脉瘤患者，413例为主髂动脉闭塞性疾病患者。汇总分析表明，腹主动脉瘤患者腹股沟疝风险增加2.9倍（比值比2.85，95%置信区间1.71-4.77，p<0.0001），切口疝风险增加2.8倍（2.79，1.88-4.13，p<0.0001）。在调整其他已知风险因素后，腹主动脉瘤患者切口疝风险增加5倍（5.45，2.48-11.94，p<0.0001）。
与主髂动脉闭塞性疾病患者相比，腹主动脉瘤患者腹股沟疝和术后切口疝的风险似乎增加了约3倍。需要进行一项大型多中心前瞻性研究来证实本评价的结果。
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