Department of Surgery and Center for Minimally Invasive Surgery, Academic Teaching, Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstrasse 6, 13585, Berlin, Germany.
Department of General, Visceral, Vascular and Thoracic Surgery, Ernst Von Bergmann Hospital, Charlottenstrasse 72, 14467, Potsdam, Germany.
Hernia. 2021 Oct;25(5):1169-1181. doi: 10.1007/s10029-020-02281-9. Epub 2020 Aug 3.
There are hardly any studies on the outcome of scrotal compared with medial and lateral inguinal hernias. Therefore, this present multivariable analysis of data from the Herniamed Registry compared the outcome of scrotal vs. lateral vs. medial inguinal hernias and explored the relationship between hernia localization and outcomes.
Included in the analysis were all primary elective unilateral inguinal hernias in men with scrotal, lateral or medial defect localization whose details had been entered into the Herniamed Registry by 712 participating institutions (status February 1, 2019). The relation of the hernia localization with the outcome parameters adjusted for pre-defined confounding patient- and procedure-related variables was analyzed via multivariable binary logistic models.
Details of 98,321 patients were thus available for multivariable analysis. These related to 65,932 (67.1%) lateral, 29,697 (30.2%) medial and 2,710 (2.7%) scrotal inguinal hernias. Scrotal hernias were associated with higher patient age, higher BMI, higher ASA score, larger defect, more risk factors and more frequent use of Lichtenstein repair. On the other hand, scrotal hernias were associated less commonly with preoperative pain. Multivariable analysis revealed that scrotal hernias had a highly significantly unfavorable association with postoperative complications, complication-related reoperations and general complications. But scrotal hernias had a highly significantly favorable relation with the pain rates at 1-year follow-up. Medial hernias were the hernia type most often related with recurrence and also had an unfavorable association with the pain rates at 1-year follow-up.
Scrotal inguinal hernias demonstrated a very unfavorable relation with the postoperative complication rate, the rate of complication-related reoperations and the rate of general complications. But a very favorable association with chronic pain rates was identified at 1-year follow-up. Medial inguinal hernia had an unfavorable relation with the recurrence and pain rates.
几乎没有任何研究比较阴囊疝与内侧和外侧腹股沟疝的结果。因此，本研究通过对 Herniamed 注册中心的数据进行多变量分析，比较了阴囊疝与外侧疝和内侧疝的结果，并探讨了疝定位与结果之间的关系。
本分析纳入了所有男性原发性单侧择期腹股沟疝，疝缺损部位为阴囊、外侧或内侧，712 家参与机构已将其详细信息录入 Herniamed 注册中心（截至 2019 年 2 月 1 日的状态）。通过多变量二项逻辑模型，分析疝定位与调整了预定义混杂患者和手术相关变量的结果参数之间的关系。
因此，共有 98321 例患者的详细资料可用于多变量分析。这些患者中，65932 例（67.1%）为外侧疝，29697 例（30.2%）为内侧疝，2710 例（2.7%）为阴囊疝。阴囊疝与患者年龄较大、BMI 较高、ASA 评分较高、疝缺损较大、更多危险因素和更频繁使用 Lichtenstein 修补术有关。另一方面，阴囊疝与术前疼痛较少相关。多变量分析显示，阴囊疝与术后并发症、与并发症相关的再次手术和一般并发症具有高度显著的不利关联。但是，阴囊疝与 1 年随访时的疼痛发生率具有高度显著的有利关系。内侧疝是最常与复发相关的疝类型，与 1 年随访时的疼痛发生率也存在不利关联。
阴囊疝与术后并发症发生率、与并发症相关的再次手术率和一般并发症发生率呈非常不利的关系。但是，在 1 年随访时，与慢性疼痛发生率存在非常有利的关联。内侧疝与复发和疼痛发生率呈不利关系。
