Department of Surgery, TAYS Cancer Center, Tampere, Finland.
Abdominal Center, Helsinki University and University Hospital, Helsinki, Finland.
Scand J Urol. 2022 Jun;56(3):191-196. doi: 10.1080/21681805.2022.2065357. Epub 2022 Apr 22.
A nationwide population-based register study will evaluate the risk of postoperative inguinal hernia repair after primary curative-intent treatment of prostate carcinoma (PCa).
Several previous studies have suggested an increased risk of inguinal hernia repair after prostatectomy. Only a few studies have compared the risk by PCa treatment modalities.
Data were collected between the years 1998 and 2016 from the national hospital discharge database HILMO and between the years 1998 and 2015 from the Finnish cancer registry to identify all men with prostate cancer with data on primary treatment available and information on inguinal hernia diagnoses and procedures among them. The risk of inguinal hernia repair among men managed with prostatectomy was compared to those treated with radiation therapy. Participants treated with prostatectomy were analyzed as a whole and separately stratified into subgroups managed with mini-invasive or open surgery. Multivariate Cox regression with adjustment for age and comorbidities was used for analysis.
A total of 7207 cases of PCa were included in the study. 4595 men were treated with radical prostatectomy and 2612 with radiation therapy. Overall, the risk of hernia repair was higher among men treated with prostatectomy compared to men who received radiation therapy as the primary PCa treatment (HR 1.42, 95% CI 1.14-1.77). The risk did not differ markedly by the prostatectomy method.
Prostate cancer treatment with prostatectomy is associated with an increased risk of inguinal hernia surgery than external beam radiation therapy treatment. This risk should be taken into account when planning PCa treatment.
一项全国范围内基于人群的登记研究将评估初次根治性治疗前列腺癌（PCa）后行腹股沟疝修补术的风险。
几项先前的研究表明前列腺切除术后腹股沟疝修补术的风险增加。只有少数研究比较了不同 PCa 治疗方式的风险。
该研究的数据来自于 1998 年至 2016 年期间的全国住院数据库 HILMO 和 1998 年至 2015 年期间的芬兰癌症登记处，以确定所有具有前列腺癌数据的男性，并对其进行初次治疗和腹股沟疝诊断及手术的信息进行分析。通过与接受放疗的患者进行比较，评估接受前列腺切除术的男性行腹股沟疝修补术的风险。对接受前列腺切除术的患者进行了整体分析，并分别对接受微创或开放性手术的亚组进行了分层分析。采用调整年龄和合并症的多变量 Cox 回归进行分析。
本研究共纳入 7207 例 PCa 患者。4595 例男性接受根治性前列腺切除术，2612 例接受放疗。总体而言，与接受放疗作为主要 PCa 治疗的男性相比，接受前列腺切除术的男性疝修补术风险更高（HR 1.42，95%CI 1.14-1.77）。不同前列腺切除术方法之间的风险差异不大。
与外部束放疗相比，前列腺癌的前列腺切除术治疗与腹股沟疝手术风险增加相关。在规划 PCa 治疗时应考虑到这一风险。
