Department of Surgery, Seoul National University College of Medicine, and Seoul National University Hospital, Healthcare System Gangnam Center, 101 Daehango (28 Yongon-dong), Jongno-Gu, Seoul, 110-744, Korea.
World J Surg. 2011 Jun;35(6):1229-33; discussion 1234. doi: 10.1007/s00268-011-1007-9.
Although inguinal hernia in patients with liver cirrhosis (LC) is not uncommon, literature comparing operative complications and long-term recurrence rate after inguinal hernia repair in LC patients and non-LC patients is limited.
A total of 780 eligible patients including 129 (16.5%) patients with LC underwent inguinal hernia repair with the standard McVay procedure by a single surgeon over a 10-year period. Patients were prospectively registered and clinical data were analyzed retrospectively.
In the LC group, 45 patients were of Child-Turcotte-Pugh (CTP) class A (34.9%), 66 were class B (51.1%), and 18 were class C (14.0%). Eighty-one patients with LC (62.8%) had ascites at the time of operation. Postoperative complications occurred in 14 LC patients (10.9%). Complication rate was unrelated to CTP class (A:B:C=11.1%:9.1%:16.7%; P=0.69) and was not higher than among non-LC patients (6.8%; P=0.11). Two LC patients (1.6%) of CTP class C died postoperatively from hepatic failure. In LC group patients, median follow-up was 22.9 months and recurrence developed in three (2.3%). Cumulative recurrence rates were not significantly different between the LC and non-LC patient groups (P=0.87). The cumulative rate of contralateral side hernia development was also similar between the two groups (P=0.63).
Our results indicate that the incidence of postoperative complications and long-term recurrence after inguinal hernia repair in LC patients does not differ from that in non-LC patients. Elective repair of symptomatic inguinal hernia in patients with cirrhosis should be advocated.
尽管肝硬化（LC）患者的腹股沟疝并不少见，但比较 LC 患者和非 LC 患者行腹股沟疝修补术后手术并发症和长期复发率的文献有限。
在过去 10 年中，一位外科医生采用标准的 McVay 手术共为 780 例符合条件的患者（包括 129 例（16.5%）LC 患者）进行了腹股沟疝修补术。前瞻性登记患者并回顾性分析临床资料。
在 LC 组中，45 例患者为 Child-Turcotte-Pugh（CTP）A级（34.9%），66 例为 B 级（51.1%），18 例为 C 级（14.0%）。手术时 81 例 LC 患者（62.8%）有腹水。LC 组 14 例（10.9%）患者术后发生并发症。并发症发生率与 CTP 分级无关（A：B：C=11.1%：9.1%：16.7%；P=0.69），且不高于非 LC 患者（6.8%；P=0.11）。2 例 CTP 级 C 的 LC 患者术后因肝功能衰竭死亡。LC 组患者中位随访时间为 22.9 个月，3 例（2.3%）复发。LC 组和非 LC 组患者的累积复发率无显著差异（P=0.87）。两组患者对侧疝的累积发生率也相似（P=0.63）。
我们的结果表明，LC 患者行腹股沟疝修补术后的术后并发症发生率和长期复发率与非 LC 患者无差异。应提倡对有症状的肝硬化患者进行择期腹股沟疝修补术。
