Department of Surgery, Køge Hospital, University Hospital of Copenhagen, Copenhagen, Denmark.
Hernia. 2013 Apr;17(2):211-5. doi: 10.1007/s10029-012-0960-z. Epub 2012 Jul 14.
Elective repair for umbilical or epigastric hernia is a frequent minor surgical procedure. Several studies have demonstrated chronic pain after groin hernia repair but long-term complaints have been only scarcely studied. This study was undertaken to investigate long-term pain and discomfort after open repair for small umbilical or epigastric hernias.
This is a retrospective study with prospective long-term follow-up. Only elective primary umbilical or epigastric hernias with an open mesh or sutured repair were included. A structured follow-up questionnaire was sent to all patients regarding verbal rating scores (VRS) of pain and discomfort (no, little, moderate, or severe) and recurrence. Patients with suspected recurrence were clinically examined.
There were 139 eligible patients, and 132 patients answered the questionnaire (95 % response rate). The median follow-up time was 36 months (range 15-85), and defect size was 1.0 cm (0.2-8.0). Sixteen patients reported moderate or severe pain and/or discomfort (12 %, 95 % confidence interval (CI): 6-18). The cumulated risk of recurrence was 11.5 %. Of the 15 patients with clinical recurrence or reoperation for recurrence, 5 patients reported moderate/severe complaints (31 %) whereas 11 of the remaining 116 patients with no recurrence (10 %) reported moderate/severe complaints (P = 0.014).
Surprisingly, many patients complained about pain and discomfort 3 years after elective repair for a small umbilical or epigastric hernia.
择期修复脐疝或上腹疝是一种常见的小型外科手术。多项研究表明，腹股沟疝修补术后会出现慢性疼痛，但长期以来，人们对其相关的抱怨研究甚少。本研究旨在调查开放性小脐疝或上腹疝修补术后的长期疼痛和不适。
这是一项回顾性研究，具有前瞻性的长期随访。仅纳入择期的原发性脐疝或上腹疝，采用开放式网片或缝合修复。对所有患者发送了一份结构化的随访问卷，内容包括疼痛和不适的口头评分（VRS）（无、轻微、中度或重度）和复发情况。对疑似复发的患者进行临床检查。
共有 139 例符合条件的患者，其中 132 例患者回答了问卷（95%的应答率）。中位随访时间为 36 个月（范围 15-85 个月），缺损大小为 1.0cm（0.2-8.0cm）。16 例患者报告有中度或重度疼痛和/或不适（12%，95%置信区间（CI）：6-18%）。复发的累积风险为 11.5%。在 15 例有临床复发或因复发而再次手术的患者中，有 5 例（31%）报告有中度/重度的不适，而在 116 例无复发的患者中，有 11 例（10%）报告有中度/重度的不适（P=0.014）。
令人惊讶的是，许多患者在择期修复小脐疝或上腹疝 3 年后仍会抱怨疼痛和不适。
