Nishiwada Satoshi, Ishikawa Hirofumi, Tsuji Yasuko, Nakamura Kota, Mukogawa Tomohide, Matsusaka Masanori, Ko Saiho, Watanabe Akihiko
Department of Surgery, Nara Prefectural Nara Hospital, 1-30-1 Hiramatsu, Nara, 631-0846, Japan,
Surg Today. 2015 Jan;45(1):57-62. doi: 10.1007/s00595-014-0880-x. Epub 2014 Mar 15.
A femoral hernia is a relatively rare condition, and no standard surgical methods have so far been established. In this study, we investigated the development of a femoral hernia after inguinal herniorrhaphy.
A total of 1,969 patients who underwent surgery for an inguinal hernia from April 1992 to March 2012 were enrolled in this study. The patients were composed of 1,934 (98.2 %) inguinal hernia and 35 (1.8 %) femoral hernia patients. Of these, we retrospectively studied the femoral hernia cases with reference to the use of inguinal herniorrhaphy.
Of all 35 femoral hernia cases, six cases (17.1 %) were femoral type recurrences after inguinal herniorrhaphy performed by the conventional or mesh plug methods. The surgical methods used for the 35 cases were mesh plug repair in 15 cases (42.9 %), the Kugel patch method in seven (20.0 %) and conventional repair in 13 patients (37.2 %). Inguinal type recurrences developed in three cases (8.6 %) that were re-repaired by mesh plug repair or sac resection. There were no femoral or inguinal type recurrences after Kugel patch repair for a femoral hernia.
The results of this study suggested the importance of repairing all hernia orifices when repairing a groin hernia. The Kugel patch repair method is available for all inguinal region hernias by the same approach, and it seems to be useful for preventing the development of recurrence after surgery.
股疝是一种相对罕见的病症，迄今为止尚未建立标准的手术方法。在本研究中，我们调查了腹股沟疝修补术后股疝的发生情况。
本研究纳入了1992年4月至2012年3月期间接受腹股沟疝手术的1969例患者。患者包括1934例（98.2%）腹股沟疝患者和35例（1.8%）股疝患者。其中，我们参照腹股沟疝修补术的使用情况对股疝病例进行了回顾性研究。
在所有35例股疝病例中，6例（17.1%）是采用传统方法或网塞法进行腹股沟疝修补术后出现的股疝类型复发。35例患者采用的手术方法为：15例（42.9%）采用网塞修补术，7例（20.0%）采用Kugel补片法，13例（37.2%）采用传统修补术。3例（8.6%）腹股沟疝类型复发，这些病例通过网塞修补术或疝囊切除术进行了再次修补。股疝采用Kugel补片修补术后未出现股疝或腹股沟疝类型复发。
本研究结果提示在修补腹股沟疝时修复所有疝孔的重要性。Kugel补片修补法可通过相同的方法用于所有腹股沟区疝，似乎对预防术后复发的发生有用。
