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女性腹股沟疝——文献综述

Groin Hernias in Women-A Review of the Literature.

作者信息

Köckerling Ferdinand, Koch Andreas, Lorenz Ralph

机构信息

Department of Surgery and Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Berlin, Germany.

Hernia Center Cottbus, Cottbus, Germany.

出版信息

Front Surg. 2019 Feb 11;6:4. doi: 10.3389/fsurg.2019.00004. eCollection 2019.

Abstract

To date, there are few studies and no systematic reviews focusing specifically on groin hernia in women. Most of the existing knowledge comes from registry data. This present review now reports on such findings as are available on groin hernia in women. A systematic search of the available literature was performed in September 2018 using Medline, PubMed, Google Scholar, and the Cochrane Library. For the present analysis 80 publications were identified. The lifetime risk of developing a groin hernia in women is 3-5.8%. The proportion of women in the overall collective of operated groin hernias is 8.0-11.5%. In women, the proportion of femoral hernias is 16.7-37%. Risk factors for development of a groin hernia in women of high age and with a positive family history. A groin hernia during pregnancy should not be operated on. The rate of emergency procedures in women, at 14.5-17.0%, is 3 to 4-fold higher than in men and at 40.6% is even higher for femoral hernia. Therefore, watchful waiting is not indicated in women. During surgical repair of groin hernia in females the presence of a femoral hernia should always be excluded and if detected should be repaired using a laparo-endoscopic or open preperitoneal mesh technique. A higher rate of chronic postoperative inguinal pain must be expected in females. Special characteristics must be taken into account for repair of groin hernia in women.

摘要

迄今为止,专门针对女性腹股沟疝的研究较少,也没有系统评价。现有的大部分知识来自登记数据。本综述报告了有关女性腹股沟疝的现有研究结果。2018年9月,我们使用Medline、PubMed、谷歌学术和考克兰图书馆对现有文献进行了系统检索。本次分析共纳入80篇文献。女性发生腹股沟疝的终生风险为3%-5.8%。在接受手术治疗的腹股沟疝患者中,女性占8.0%-11.5%。在女性中,股疝的比例为16.7%-37%。高龄和有家族史的女性是发生腹股沟疝的危险因素。孕期腹股沟疝不应进行手术。女性急诊手术率为14.5%-17.0%,比男性高3至4倍,股疝的急诊手术率甚至高达40.6%。因此,不建议女性采用观察等待策略。在女性腹股沟疝手术修复过程中,应始终排除股疝的存在,若发现股疝,应采用腹腔镜-内镜或开放腹膜前补片技术进行修复。女性术后慢性腹股沟疼痛的发生率较高。女性腹股沟疝修复必须考虑其特殊特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfe3/6378890/6df91123e90d/fsurg-06-00004-g0001.jpg

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