Menakuru S R, Philip T, Ravindranath N, Fisher P W
Department of General Surgery, Caithness General Hospital, Wick, KW1 5NS, UK.
Surgeon. 2006 Dec;4(6):343-5. doi: 10.1016/s1479-666x(06)80109-5.
Audit of inguinal hernia repair is important in view of the magnitude of the problem and the fact that it is a common operation often performed by surgical trainees. Due to the disparity of the results of various workers with regard to the rate of complications, individual surgeons have been advised to audit their patients' outcomes.
Retrospective audit was performed, of all the inguinal hernias repaired between 1997 and 2003 inclusive, at two rural hospitals in northern Scotland, under a single consultant. Data were gathered from a hospital database and by means of postal questionnaire specifically aimed at wound complications, recurrence and chronic groin pain.
One hundred and sixty-three inguinal hernias were repaired during this period. One hundred and fifty-eight questionnaires were sent to patients ascertained to be living at the time of audit initiation with a response from 129 (86%). At a mean follow-up of 4.34 years, no recurrences were noted and eight patients complained of chronic groin pain of whom only three (1.5%) were experiencing moderate to severe pain. The results achieved by senior house officers were comparable to those obtained by the senior surgeon.
The incidence of recurrence of hernia after open mesh repair of inguinal hernias is very low. Excellent outcomes can be obtained for inguinal hernia even at remote and rural hospitals in the hands of both experienced and trainee surgeons
鉴于腹股沟疝修补问题的严重性以及该手术是外科实习医生常做的常见手术，对腹股沟疝修补进行审计很重要。由于不同研究者在并发症发生率方面的结果存在差异，已建议个体外科医生对其患者的治疗结果进行审计。
对1997年至2003年（含）期间在苏格兰北部两家乡村医院由单一顾问医生主刀修补的所有腹股沟疝进行回顾性审计。数据从医院数据库收集，并通过专门针对伤口并发症、复发和慢性腹股沟疼痛的邮政问卷收集。
在此期间共修补了163例腹股沟疝。向确定在审计开始时仍在世的患者发送了158份问卷，收到129份回复（86%）。平均随访4.34年，未发现复发情况，8例患者主诉慢性腹股沟疼痛，其中只有3例（1.5%）经历中度至重度疼痛。住院医生取得的结果与资深外科医生相当。
腹股沟疝开放网片修补术后疝复发的发生率非常低。即使在偏远的乡村医院，由经验丰富的外科医生和实习医生操作，腹股沟疝也能取得良好的治疗效果。
