Department of Surgery, Mid Cheshire Hospitals NHS Foundation Trust, Leighton Hospital Leighton, Crewe, Cheshire CW1 4QJ, UK.
Surg Endosc. 2013 Mar;27(3):936-45. doi: 10.1007/s00464-012-2538-3. Epub 2012 Oct 17.
Traditionally, repair of an inguinal hernia has been by an open method, but laparoscopic techniques have recently been introduced and are increasing in popularity. This study aimed to compare early and late outcomes following laparoscopic and open repair of inguinal hernia.
We performed an analysis of inpatient Hospital Episode Statistics. Early-outcome criteria studied include in-hospital mortality, length of hospital stay, complications (infection, bleeding, injury to an organ, and urinary retention), and readmission. Late outcome was assessed by the need for a further inguinal hernia repair on the same side.
Between April 2002 and April 2004 there were 125,342 patients who underwent inguinal hernia repair and were included in the analysis. They were followed until April 2009. There were no differences in postoperative stay between the laparoscopic and open groups except for the laparoscopic bilateral hernia repair patients who had a shorter stay than the open group. Infection and bleeding were more common following open repair, whilst urinary retention and injury to an organ were more frequent after laparoscopic repair. Reoperation for another inguinal hernia was more common after laparoscopic (4.0 %) than after open repair of primary inguinal hernia (2.1 %), mostly in the first year after surgery. There was no difference in reoperation rate following repair of a recurrent inguinal hernia. Consultant caseload was strongly inversely correlated with reoperation following laparoscopic but not open repair of primary inguinal hernia.
Reoperation is more common after laparoscopic than after open repair of primary but not recurrent inguinal hernia. Surgeons with a low laparoscopic hernia repair caseload have an increased reoperation rate following laparoscopic repair of primary inguinal hernia. The increase in reoperation rate following laparoscopic repair is seen in the first year or two following the initial surgery.
传统上，腹股沟疝的修复采用开放式方法，但最近引入了腹腔镜技术，并且越来越受欢迎。本研究旨在比较腹腔镜和开放式腹股沟疝修复的早期和晚期结果。
我们对住院患者的病例统计数据进行了分析。研究的早期结果标准包括住院期间死亡率、住院时间、并发症（感染、出血、器官损伤和尿潴留）和再入院。晚期结果通过同侧需要进一步进行腹股沟疝修复来评估。
在 2002 年 4 月至 2004 年 4 月期间，有 125342 名患者接受了腹股沟疝修复，并纳入了分析。他们一直随访到 2009 年 4 月。腹腔镜和开放式组之间的术后住院时间没有差异，除了腹腔镜双侧疝修复患者的住院时间比开放式组短。开放性修复后感染和出血更为常见，而腹腔镜修复后尿潴留和器官损伤更为常见。腹腔镜（4.0%）后再次进行另一个腹股沟疝手术比开放式（2.1%）后更常见原发性腹股沟疝，主要是在手术后的第一年。修复复发性腹股沟疝后再次手术的比率没有差异。顾问手术量与腹腔镜但不是开放式修复原发性腹股沟疝后的再次手术强烈呈负相关。
腹腔镜修复原发性而非复发性腹股沟疝后再次手术更为常见。腹腔镜疝修复手术量较低的外科医生，在腹腔镜修复原发性腹股沟疝后再次手术的比率较高。腹腔镜修复后再次手术率的增加发生在初始手术后的一两年内。
