Miller A R, van Heerden J A, Naessens J M, O'Brien P C
Section of Gastroenterologic and General Surgery, Mayo Clinic, Rochester, Minnesota 55905.
Ann Surg. 1991 Mar;213(3):272-6. doi: 10.1097/00000658-199103000-00016.
The timing of bilateral hernia repair remains controversial. Because of reported high recurrence rates after simultaneous bilateral repair, staged procedures have been suggested. This study determined recurrence and complication rates of unilateral versus simultaneous bilateral repair. Of 659 patients undergoing hernia repair between 1974 and 1980, 333 underwent unilateral repair and 329 had simultaneous bilateral repair. More than 90% of patients were followed until death or a minimum of 60 months (median, 104 months). Perioperative complications were associated with 18% of repairs. More morbidity occurred in the bilateral group. However complication rates for specific events were not significantly different, except for urinary retention, which occurred in 20 patients (6.1%) of the unilateral group and 49 (15%) of the bilateral group (p less than 0.001). Overall 25 recurrences occurred in the unilateral group and 31 in the bilateral group. Recurrence rates at 5 and 9 years were, respectively, 4.8% and 8.8% in the unilateral group and 5.0% and 9.1% in the bilateral group (p = 0.861). These data suggest that simultaneous bilateral inguinal herniorrhaphy does not result in increased rates of most postoperative complications or recurrence when compared with unilateral repair.
双侧疝修补术的时机仍存在争议。由于有报道称同期双侧修补术后复发率较高，因此有人建议采用分期手术。本研究确定了单侧修补与同期双侧修补的复发率和并发症发生率。在1974年至1980年间接受疝修补术的659例患者中，333例行单侧修补，329例行同期双侧修补。超过90%的患者随访至死亡或至少60个月（中位数为104个月）。围手术期并发症与18%的修补术相关。双侧组的发病率更高。然而，除尿潴留外，特定事件的并发症发生率无显著差异，单侧组有20例患者（6.1%）发生尿潴留，双侧组有49例（15%）发生尿潴留（p<0.001）。单侧组共发生25例复发，双侧组共发生31例复发。单侧组5年和9年的复发率分别为4.8%和8.8%，双侧组分别为5.0%和9.1%（p = 0.861）。这些数据表明，与单侧修补相比，同期双侧腹股沟疝修补术不会导致大多数术后并发症或复发率增加。
