Ipswich Hospital, Chelmsford Avenue, Ipswich, QLD, 4305, Australia.
Logan Hospital, Corner Meadowbrook and Loganlea Roads, Meadowbrook, QLD, 4131, Australia.
Hernia. 2019 Dec;23(6):1061-1064. doi: 10.1007/s10029-019-01925-9. Epub 2019 Mar 9.
General surgeons frequently see patients with groin lumps and pain. However, in the absence of a lump, an ultrasound scan identified groin hernia is a diagnostic and management challenge. Some surgeons recommend inguinal hernia surgery while others do not. The outcome of non-operative management is uncertain.
This study represents a minimum 3-year follow-up of all non-operatively managed patients seen in general surgical outpatient clinic over a 12-month period. To be included, patients needed to meet all four criteria: groin pain, no clinical hernia, groin hernia identified on ultrasound scan requested by the general practitioner and non-operative management. Patients were interviewed via a standardised telephone survey. Primary outcome measure was groin pain which was assessed with the Sheffield Pain score.
From July 2014 to June 2015, 67 patients met the inclusion criteria. 42 participated (37 men and 5 women). Two-thirds were pain free (68%). Only 2 patients underwent hernia surgery. Women were more likely to describe developing a lump (60% vs 14%; p = 0.013), to see a surgeon (40% vs 8%; p = 0.039) and undergo hernia surgery (20% vs 3% p = 0.088).
At least in the medium term, non-operative management of men who present with groin pain (with an ultrasound scan reporting a hernia but no lump) is reasonable.
普通外科医生经常会遇到腹股沟肿块和疼痛的患者。然而，在没有肿块的情况下，超声扫描发现腹股沟疝是一个诊断和治疗的挑战。一些外科医生建议进行腹股沟疝手术，而另一些则不建议。非手术治疗的结果不确定。
本研究代表了在 12 个月内普通外科门诊就诊的所有非手术治疗患者的至少 3 年随访。符合纳入标准的患者需要满足以下所有四个标准：腹股沟疼痛、无临床疝、超声扫描发现腹股沟疝（由全科医生要求）和非手术治疗。通过标准电话调查对患者进行访谈。主要结局指标为腹股沟疼痛，采用谢菲尔德疼痛评分进行评估。
从 2014 年 7 月至 2015 年 6 月，共有 67 名患者符合纳入标准。42 名患者参与了研究（37 名男性，5 名女性）。三分之二的患者无疼痛（68%）。只有 2 名患者接受了疝手术。女性更有可能出现肿块（60%比 14%；p=0.013）、看外科医生（40%比 8%；p=0.039）和接受疝手术（20%比 3%；p=0.088）。
至少在中期，对于出现腹股沟疼痛（超声扫描报告有疝但无肿块）的男性患者，非手术治疗是合理的。
