Köckerling F, Adolf D, Lorenz R, Stechemesser B, Kuthe A, Conze J, Lammers B, Fortelny R, Mayer F, Zarras K, Reinpold W, Hoffmann H, Weyhe D
Department of Surgery and Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstrasse 6, 13585, Berlin, Germany.
StatConsult GmbH, Halberstädter Strasse 40 a, 39112, Magdeburg, Germany.
Hernia. 2022 Feb;26(1):201-215. doi: 10.1007/s10029-021-02417-5. Epub 2021 Apr 24.
Using registry analyses, a large number of influencing factors on the perioperative outcome of groin hernia repair has been identified. The interactions between several influencing factors and differences in the influencing value have to date been inadequately investigated.
This retrospective analysis of prospectively collected data from the Herniamed Registry included all fully documented cases with minimum age of 16 years and groin hernia repair. Patients were assigned to the risk groups unilateral, bilateral, recurrent and emergency groin hernia repair. Multivariable analysis was performed to investigate the influence of confirmatory defined patient- and procedure-related characteristics on the outcome parameters intraoperative, postoperative general and postoperative surgical complications, complication-related reoperation and total perioperative complications.
A highly significantly unfavorable association with the total perioperative complication rate was identified for emergency groin hernia repair, scrotal hernia, anticoagulant medication and coagulopathy. A significantly unfavorable relation with the total perioperative complication rate was found for recurrence procedure, bilateral repair, high age, ASA score III/IV, femoral hernia, antithrombotic medication, smoking, COPD and corticosteroid medication. A significantly favorable correlation with the total perioperative complication rate was observed for the laparo-endoscopic techniques, smaller defects, female gender, normal weight and medial hernia.
Both the number of potential influencing factors and their influencing value on the perioperative outcome should be considered when estimating the individual risk of a patient with groin hernia repair.
通过登记分析，已确定了大量影响腹股沟疝修补术围手术期结果的因素。迄今为止，对几个影响因素之间的相互作用以及影响值的差异尚未进行充分研究。
本研究对前瞻性收集的来自Herniamed登记处的数据进行回顾性分析，纳入了所有年龄至少16岁且有腹股沟疝修补术完整记录的病例。患者被分为单侧、双侧、复发性和急诊腹股沟疝修补术风险组。进行多变量分析以研究经确认的特定患者和手术相关特征对术中、术后一般和术后手术并发症、并发症相关再次手术以及围手术期总并发症等结果参数的影响。
发现急诊腹股沟疝修补术、阴囊疝、抗凝药物和凝血功能障碍与围手术期总并发症发生率呈高度显著的不利关联。复发手术、双侧修补、高龄、美国麻醉医师协会（ASA）评分III/IV、股疝、抗血栓药物、吸烟、慢性阻塞性肺疾病（COPD）和皮质类固醇药物与围手术期总并发症发生率呈显著不利关系。腹腔镜内镜技术、较小缺损、女性、正常体重和内侧疝与围手术期总并发症发生率呈显著有利相关性。
在评估腹股沟疝修补术患者的个体风险时，应考虑潜在影响因素的数量及其对围手术期结果的影响值。
