根治性前列腺切除术后腹股沟疝修补术的发生率：一项基于人群的全国性研究。
Incidence of groin hernia repair after radical prostatectomy: a population-based nationwide study.
机构信息
*Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden †Departments of Surgery ‡Urology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg Sweden §Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden ¶Department of Surgery, Urology Service, Memorial Sloan-Kettering Cancer Center, New York, NY ∥Department of Surgery, Östersund Hospital, Östersund, Sweden.
出版信息
Ann Surg. 2014 Jun;259(6):1223-7. doi: 10.1097/SLA.0b013e3182975c88.
OBJECTIVE
To assess the incidence of groin hernia repair after radical prostatectomy for prostate cancer compared with the incidence in a control population without prostate cancer in a nationwide, population-based study.
BACKGROUND
Recent reports indicate an increase in the incidence of groin hernia repair after radical prostatectomy. Inadequate knowledge of the incidence of groin hernia in the general population makes this information hard to interpret.
METHODS
Information was retrieved from the Prostate Cancer Database (PCBaSe) and Swedish Hernia Register for events between 1998 and 2010. The incidence of groin hernia surgery was calculated for a group of men treated with radical prostatectomy (open and minimally invasive) and for a group treated with radiation therapy, and these were compared with the incidence in a control cohort of men matched for age and county of residence. Multivariate analysis was used to assess the hazard ratio (HR) of groin hernia repair according to age, tumor risk category, and Charlson Comorbidity Index.
RESULTS
A total of 28,608 cases and 105,422 controls were included in the study. Men treated with radical prostatectomy and radiation therapy had a significantly higher incidence of groin hernia repair than the control cohort: HR: 3.95 (95% confidence interval: 3.70-4.21) for retropubic prostatectomy, HR: 3.37 (95% confidence interval: 2.95-3.87) for minimally invasive prostatectomy, and HR: 1.84 (95% confidence interval: 1.66-2.04) for radiation therapy.
CONCLUSIONS
An almost 4-fold increase in groin hernia repair was observed after radical prostatectomy compared with controls, and men who received radiation therapy had an almost 2-fold increase in incidence. As well as postoperative changes in the abdominal wall, increased vigilance for groin hernia seems to be important for the increased incidence of groin hernia repair seen after radical prostatectomy or radiation therapy for prostate cancer.
目的
在一项全国性基于人群的研究中，评估前列腺癌根治术后腹股沟疝修补术的发生率，并与无前列腺癌的对照组进行比较。
背景
最近的报告表明，前列腺癌根治术后腹股沟疝修补术的发生率有所增加。由于对普通人群中腹股沟疝的发病率了解不足，因此难以解释这一信息。
方法
从前列腺癌数据库（PCBaSe）和瑞典疝登记处获取 1998 年至 2010 年间的事件信息。计算了一组接受根治性前列腺切除术（开放和微创）治疗的男性和一组接受放射治疗的男性的腹股沟疝手术发生率，并与年龄和居住地相匹配的对照组男性的发生率进行比较。采用多变量分析评估年龄、肿瘤风险类别和 Charlson 合并症指数对腹股沟疝修补术的风险比（HR）。
结果
共有 28608 例患者和 105422 例对照纳入研究。接受根治性前列腺切除术和放射治疗的男性腹股沟疝修补术的发生率明显高于对照组：经耻骨后前列腺切除术的 HR 为 3.95（95%置信区间：3.70-4.21），微创前列腺切除术的 HR 为 3.37（95%置信区间：2.95-3.87），放射治疗的 HR 为 1.84（95%置信区间：1.66-2.04）。
结论
与对照组相比，根治性前列腺切除术后腹股沟疝修补术的发生率增加了近 4 倍，接受放射治疗的男性腹股沟疝的发生率增加了近 2 倍。除了术后腹壁变化外，对于前列腺癌根治性前列腺切除术或放射治疗后腹股沟疝修补术发生率的增加，似乎需要更加警惕腹股沟疝。
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