Center for Perioperative Optimization, Department of Surgery, Herlev and Gentofte Hospitals, University of Copenhagen, Borgmester Ib Juuls Vej 1, 2730, Herlev, DK, Denmark.
Langenbecks Arch Surg. 2021 Sep;406(6):1733-1738. doi: 10.1007/s00423-021-02293-8. Epub 2021 Aug 19.
Obturator hernias are rare and associated with high mortality. However, the optimal surgical approach remains unknown. We aimed to investigate the available evidence and examine the surgical details regarding obturator hernia defect closure as well as the recurrence rates of the different approaches.
We reported this scoping review according to the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analysis Extension for Scoping Reviews) and registered the protocol online. A comprehensive literature search in five different databases was conducted. The population was patients undergoing surgery for obturator hernia. Articles were included for data charting if the management of the hernia defect was reported. Data regarding surgical details, and hernia recurrence were extracted.
A total of 1299 patients from 313 articles were included. In total, 937 patients underwent open obturator hernia repair, in which 992 hernias were repaired (including some bilateral obturator hernias). A total of 295 patients underwent laparoscopic repair for 341 obturator hernias, and for the remaining 67 patients, type of surgery was not reported. For open surgery, suture repair was the most common method of repair (n = 508, 51%) with a recurrence rate of 10%. For laparoscopic surgery, the most common repair of the defect was mesh repair (n = 299, 88%) with no reported recurrences.
Open surgery with primary suture repair is the most common method of repair for obturator hernia but is associated with a recurrence rate of 10%. Laparoscopic mesh repair is becoming more common and have seemingly very low recurrence rates and may be a better method of repair.
闭孔疝罕见，死亡率高。然而，最佳的手术方法仍不清楚。我们旨在调查现有证据，并检查闭孔疝缺损闭合的手术细节，以及不同方法的复发率。
我们按照 PRISMA-ScR（系统评价和荟萃分析扩展的首选报告项目）报告了这个范围综述，并在网上注册了方案。在五个不同的数据库中进行了全面的文献搜索。研究人群为接受闭孔疝手术的患者。如果报告了疝缺损的处理方法，则将文章纳入数据图表。提取有关手术细节和疝复发的数据。
共纳入 313 篇文章中的 1299 名患者。共有 937 名患者接受了开放式闭孔疝修补术，其中 992 例疝（包括一些双侧闭孔疝）接受了修补。共有 295 名患者接受了腹腔镜修补术，用于 341 例闭孔疝，其余 67 名患者未报告手术类型。对于开放式手术，缝合修复是最常见的修复方法（n=508，51%），复发率为 10%。对于腹腔镜手术，最常见的缺损修复方法是网片修复（n=299，88%），无报告复发。
开放式手术采用原发性缝合修复是闭孔疝最常见的修复方法，但复发率为 10%。腹腔镜网片修复越来越常见，复发率似乎很低，可能是一种更好的修复方法。
