Chesley Patrick M, Black George E, Martin Matthew J, Johnson Eric K, Maykel Justin A, Steele Scott R
Department of Surgery, Madigan Army Medical Center, Ft. Lewis, WA, USA.
Department of Surgery, UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA.
Am J Surg. 2015 May;209(5):783-6; discussion 786. doi: 10.1016/j.amjsurg.2014.12.019. Epub 2015 Feb 12.
Pathological examination of hernia sac specimens adds additional steps and cost to a surgical procedure but has no proven benefit. Although well studied in pediatrics, there are limited data in the adult literature pertaining to this practice.
This is a retrospective analysis from a single institution referral center over a 4-year period (2007 to 2011). All inguinal, incisional, ventral, and umbilical hernia repairs greater than 18 years of age were included.
A total of 1,216 inguinal (55.4%), incisional (11.4%), umbilical (21.5%), or ventral hernia (11.7%) repairs were included. In 246 cases (20.2%), hernia sac specimens were sent to pathology (open 96.7%; laparoscopic 3.3%). There were no cases in which management of the patient changed because of the final results.
The rarity of changes in diagnosis and treatment from routine pathologic examination of a hernia sac does not justify this practice and indicates that it may be omitted except in unique circumstances.
疝囊标本的病理检查会给手术增加额外步骤和成本，但尚未证实其有实际益处。尽管在儿科对此有充分研究，但成人文献中关于这种做法的数据有限。
这是一项来自单一机构转诊中心的为期4年（2007年至2011年）的回顾性分析。纳入所有年龄大于18岁的腹股沟疝、切口疝、腹疝和脐疝修补术。
共纳入1216例腹股沟疝（55.4%）、切口疝（11.4%）、脐疝（21.5%）或腹疝（11.7%）修补术。246例（20.2%）疝囊标本被送去做病理检查（开放手术占96.7%；腹腔镜手术占3.3%）。没有因最终结果而改变患者治疗方案的病例。
疝囊常规病理检查导致诊断和治疗改变的情况罕见，说明这种做法不合理，表明除特殊情况外可省略该检查。
