Third Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Rimini 1 Str., Chaidari, 12462, Athens, Greece.
Second Propedeutic Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.
Hernia. 2020 Oct;24(5):951-959. doi: 10.1007/s10029-020-02215-5. Epub 2020 May 25.
To identify and sum all available evidence pertaining to the management of Amyand's hernia (AH).
A systematic search of the MedLine, Scopus, and Google Scholar databases was performed for studies published until January 2020.
In total, 111 studies incorporating 161 patients were identified, 96 (86.4%) being case reports, 11 (9.9%) case series, and 4 (3.7%) retrospective patient cohorts. Mean patient age was 58.5 ± 19.6 years with 136 (83.9%) being males and 25 (16.1%) females. Furthermore, 149 (92.5%) cases were right-sided hernias while 12 (7.5%) cases were left-sided. Overall, 62.3% of patients presented emergently and 77.3% of patients' cohort were eventually diagnosed with incarcerated AH. Preoperative diagnosis of AH was established in 23.1% of patients and was achieved either by ultrasound (25%) or CT scan (75%). Operative findings consisted of normal appendix in 73 (45.4%) cases, uncomplicated appendicitis in 62 (38.5%) patients, and perforated appendix in 26 (16.1%). Regarding patients with appendicitis, mesh placement was reported for 17 (21.2%), herniorrhaphy was performed for 51 (63.7%) while 12 (15.1%) patients did not undergo hernia repair during the initial operation. Mesh utilization rates were significantly higher in patients with a normal appendix. Seven cases involved AH containing appendiceal neoplasms. Thirteen cases (8.6%) of postoperative complications were documented and a single case of postoperative death.
AH is a rare type of inguinal hernia usually complicated by appendicitis. Hernia reconstruction should be tailored to each patient individually according to the extent of inguinal canal inflammation.
确定并总结与安迈氏疝（AH）治疗相关的所有现有证据。
对截至 2020 年 1 月发表的研究进行了 MedLine、Scopus 和 Google Scholar 数据库的系统检索。
共确定了 111 项研究，纳入了 161 例患者，其中 96 项（86.4%）为病例报告，11 项（9.9%）为病例系列，4 项（3.7%）为回顾性患者队列。患者平均年龄为 58.5±19.6 岁，男性 136 例（83.9%），女性 25 例（16.1%）。此外，149 例（92.5%）为右侧疝，12 例（7.5%）为左侧疝。总体而言，62.3%的患者为急症就诊，77.3%的患者最终被诊断为嵌顿性 AH。23.1%的患者术前明确诊断为 AH，通过超声（25%）或 CT 扫描（75%）确诊。手术发现 73 例（45.4%）阑尾正常，62 例（38.5%）单纯性阑尾炎，26 例（16.1%）阑尾穿孔。对于患有阑尾炎的患者，17 例（21.2%）行网片修补，51 例（63.7%）行疝修补术，12 例（15.1%）患者在初次手术时未行疝修补术。阑尾正常的患者网片使用率明显较高。7 例包含阑尾肿瘤的 AH。术后并发症 13 例（8.6%），1 例术后死亡。
AH 是一种罕见的腹股沟疝，通常与阑尾炎有关。应根据腹股沟管炎症的程度，对每位患者进行个体化的疝重建。
