Hellspong Gustaf, Gunnarsson Ulf, Dahlstrand Ursula, Sandblom Gabriel
Department of pediatrics, Karolinska University Hospital Huddinge, 141 86, Stockholm, Sweden.
Department of Surgery and Perioperative Science, Umeå University, Umeå, Sweden.
Langenbecks Arch Surg. 2017 Mar;402(2):219-225. doi: 10.1007/s00423-016-1519-8. Epub 2016 Dec 7.
Diabetes is a known risk factor for early postoperative complications. Even so, the incidence of acute postoperative complications following routine hernia surgery is seldom described, and the risk for reoperation for recurrence has hardly been studied. Our aim was to explore if diabetes is a significant risk factor for complications after inguinal hernia surgery.
All inguinal hernia repairs registered in the Swedish Hernia Register between 2002 and 2011 were identified. Information on comorbidity and postoperative complications was obtained through cross-referencing with the National Patient Register at the National Board of Health and Welfare. Complicated diabetes was defined as diabetes with secondary manifestations (corresponding to aDCSI >0). The hazards for postoperative complications and reoperation for recurrence after the index hernia operation were calculated.
Altogether 162,713 inguinal hernia repairs on 143,041 patients were registered. Of these, the number of patients with diabetes was 4816 (3.4 %), including 1123 (0.8 %) patients with complicated diabetes (aDCSI > 0). A significantly increased risk for postoperative complications was observed up to 30 days after hernia surgery when adjusted for gender, age, BMI, history of liver disease, kidney disease or HIV/AIDS, type of hernia and surgical method (odds ratio 1.35, 95 % confidence interval 1.14-1.60). No significantly increased risk for reoperation up until December 31, 2011, was observed in either patient group.
Diabetes seems to increase the risk for postoperative complications within 30 days of inguinal hernia surgery, especially for complicated diabetes. Diabetes does not seem to increase the long-term risk for reoperation for recurrence.
糖尿病是术后早期并发症的已知危险因素。即便如此，常规疝修补术后急性并发症的发生率鲜有描述，复发再手术的风险也几乎未被研究。我们的目的是探讨糖尿病是否为腹股沟疝修补术后并发症的重要危险因素。
确定2002年至2011年间瑞典疝登记处登记的所有腹股沟疝修补手术。通过与国家卫生和福利委员会的国家患者登记处交叉对照，获取合并症和术后并发症的信息。复杂性糖尿病定义为伴有继发表现的糖尿病（对应糖尿病并发症严重程度分类指数>0）。计算首次疝修补术后的术后并发症及复发再手术的风险。
共登记了143041例患者的162713例腹股沟疝修补手术。其中，糖尿病患者有4816例（3.4%），包括1123例（0.8%）复杂性糖尿病患者（糖尿病并发症严重程度分类指数>0）。在对性别、年龄、体重指数、肝病、肾病或艾滋病毒/艾滋病病史、疝的类型和手术方法进行校正后，发现疝修补术后30天内术后并发症风险显著增加（比值比1.35，95%置信区间1.14 - 1.60）。在两个患者组中，直至2011年12月31日，均未观察到再手术风险显著增加。
糖尿病似乎会增加腹股沟疝修补术后30天内的术后并发症风险，尤其是复杂性糖尿病。糖尿病似乎不会增加复发再手术的长期风险。
