Mayne Medical School, School of Medicine, University of Queensland, Brisbane, QLD, Australia.
Sunshine Coast University Hospital, Birtinya, QLD, Australia.
Hernia. 2019 Aug;23(4):637-645. doi: 10.1007/s10029-018-1868-z. Epub 2018 Dec 5.
One of the most important measures of success of open inguinal herniorrhaphy is the incidence of recurrence. Reports suggest that up to 13% of all inguinal hernia repairs worldwide, irrespective of the approach, are repaired for recurrence. The reason as to why inguinal hernias recur is most likely multifactorial. The aim of this review is to evaluate the risk factors responsible for these recurrences in open suture and mesh techniques.
A search of the Medline, Embase, Science Citation Index, Current Contents and PubMed databases identified English language, peer-reviewed articles on the causes of recurrence following open inguinal herniorrhaphy published between 1990 and 2018. The search terms included 'Inguinal hernia'; 'Open methods'; 'Suture repair'; 'Mesh repair', 'Recurrence', 'Causes', 'Humans'.
The literature revealed several contributing modifiable and non-modifiable risk factors that were responsible for recurrence following open suture and mesh inguinal herniorrhaphy. These included perioperative, patient and hernia factors.
Despite the advent of laparoscopic techniques, open inguinal herniorrhaphy remains one of the most common surgical operations. With open inguinal hernia repairs, risk factors for recurrence can be broadly classified into perioperative, patient and hernia factors. Certain patient and technical risk factors are modifiable and could reduce the recurrence rate. However, many others factors are non-modifiable. It is therefore imperative that the outcome of open inguinal herniorrhaphy must be optimised by careful planning and education for both surgeons and patients to achieve the lowest possible risk of subsequent surgery for recurrence.
开放式腹股沟疝修补术成功的最重要指标之一是复发率。有报道称，全世界范围内，无论采用何种手术入路，所有腹股沟疝修补术中有高达 13%的患者因复发而需要再次手术。腹股沟疝复发的原因很可能是多因素的。本综述的目的是评估导致开放式缝合和网片技术复发的相关危险因素。
通过 Medline、Embase、Science Citation Index、Current Contents 和 PubMed 数据库检索，查找 1990 年至 2018 年间发表的关于开放式腹股沟疝修补术后复发原因的英语同行评议文章。检索词包括“腹股沟疝”；“开放式方法”；“缝合修复”；“网片修复”；“复发”；“原因”；“人类”。
文献揭示了一些导致开放式缝合和网片修补术后复发的可改变和不可改变的危险因素。这些因素包括围手术期、患者和疝的因素。
尽管腹腔镜技术已经出现，但开放式腹股沟疝修补术仍然是最常见的手术之一。对于开放式腹股沟疝修补术，复发的危险因素可大致分为围手术期、患者和疝的因素。某些患者和技术危险因素是可改变的，可以降低复发率。然而，许多其他因素是不可改变的。因此，必须通过仔细的规划和对术者和患者的教育来优化开放式腹股沟疝修补术的结果，以实现随后因复发而再次手术的风险尽可能低。
