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女性腹腔镜腹股沟疝修补术:趋势、差异和术后结果。

Laparoscopic inguinal hernia repair in women: Trends, disparities, and postoperative outcomes.

机构信息

Icahn School of Medicine at Mount Sinai, United States.

Mount Sinai St. Luke's-West, 425 West 59th Street, Suite 7B, New York, NY, 10019, United States.

出版信息

Am J Surg. 2019 Oct;218(4):726-729. doi: 10.1016/j.amjsurg.2019.07.022. Epub 2019 Jul 22.

Abstract

INTRODUCTION

This study analyzed trends in laparoscopic inguinal hernia repair over time, rates of laparoscopic repair in women, and subsequent postoperative outcomes.

METHODS

Data for 237,503 patients undergoing repair of an initial, reducible inguinal hernia were analyzed using the National Surgical Quality Improvement Program (NSQIP) database for years 2006-2017. Data were analyzed by univariate and multivariate analysis.

RESULTS

Since 2006, there was an increased proportion of laparoscopic inguinal hernia surgeries, from 20.49% in 2006 to 36.36% in 2017 (p < .001). The percentage of women with bilateral inguinal hernias that underwent laparoscopic repair was less than the percentage of men (31.58% vs. 41.43%, p < .001). Based on multivariate analysis, women were less likely to have laparoscopic hernia repair (OR 0.74, CI 0.71-0.76). Postoperative complications were overall low.

CONCLUSION

A greater proportion of inguinal hernia repairs are performed laparoscopically. Women with bilateral inguinal hernias are more likely than men to undergo open rather than laparoscopic inguinal hernia repair.

摘要

简介

本研究分析了腹腔镜腹股沟疝修补术随时间的变化趋势、女性腹腔镜修补术的比例以及随后的术后结果。

方法

利用国家手术质量改进计划(NSQIP)数据库,对 2006 年至 2017 年间 237503 例首次可复性腹股沟疝修补术患者的数据进行了分析。采用单变量和多变量分析对数据进行了分析。

结果

自 2006 年以来,腹腔镜腹股沟疝手术的比例从 20.49%增加到 2017 年的 36.36%(p<0.001)。接受腹腔镜双侧腹股沟疝修补术的女性比例低于男性(31.58%对 41.43%,p<0.001)。基于多变量分析,女性更不可能接受腹腔镜疝修补术(OR 0.74,CI 0.71-0.76)。术后并发症总体较低。

结论

越来越多的腹股沟疝修补术采用腹腔镜进行。与男性相比,女性双侧腹股沟疝更有可能接受开放而非腹腔镜腹股沟疝修补术。

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