Department of Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark.
Department of Surgery, Randers Regional Hospital, Randers, Denmark.
Hernia. 2022 Aug;26(4):1047-1052. doi: 10.1007/s10029-022-02633-7. Epub 2022 Jun 3.
Sliding hernia is a rare finding and it remains controversial if a laparoscopic or an open (Lichenstein) technique is preferable for repair of sliding hernias. The aim of this study was to investigate the risk of post-operative complications and risk of reoperation due to recurrence in patients with sliding hernia based on surgical technique.
The study included male patients receiving hernia repair between 1 January 2010 and 31 December 2017. The data was obtained from the National Danish Hernia Database.
A total of 32,396 hernia repairs were included. 13.5% presented with sliding hernia. No difference was found in postoperative complications comparing sliding and non-sliding lateral hernias (5.1% vs 4.2% at 90 days of follow up). Patients treated with a Lichenstein repair had a higher risk of minor complications compared to a laparoscopic repair, however the risk was overall low (1.9% vs 0.8%). Overall 3.1% had surgical repair of recurrence, a higher risk was found among patients with sliding hernia (4.3% vs 2.9%), particularly among those having a Lichenstein repair (OR 2.07, 95% CI 1.11-3.85).
A low risk of complications and recurrence after repair of both sliding and non-sliding hernia was found. Among patients with sliding hernia the risk of recurrence was lower in patient having hernia repair using laparoscopic technique although in both groups the risk was low. Sliding hernias can be treated safely using both Lichenstein and laparoscopic techniques.
滑动性疝是一种罕见的发现，对于滑动性疝的修复，腹腔镜或开放式（Lichtenstein）技术哪种更优仍存在争议。本研究旨在根据手术技术探讨滑动性疝患者术后并发症风险和因复发而再手术的风险。
本研究纳入了 2010 年 1 月 1 日至 2017 年 12 月 31 日期间接受疝修补术的男性患者。数据来自丹麦国家疝数据库。
共纳入 32396 例疝修补术，其中 13.5%为滑动性疝。滑动性疝和非滑动性外侧疝在术后并发症方面无差异（90 天随访时分别为 5.1%和 4.2%）。与腹腔镜修复相比，Lichtenstein 修复的患者发生轻微并发症的风险更高，但总体风险较低（1.9%比 0.8%）。总体而言，有 3.1%的患者需要手术修复复发，滑动性疝患者的风险更高（4.3%比 2.9%），尤其是接受 Lichtenstein 修复的患者（OR 2.07，95%CI 1.11-3.85）。
滑动性疝和非滑动性疝修复后并发症和复发的风险均较低。在滑动性疝患者中，腹腔镜技术修复的患者复发风险较低，尽管两组的风险均较低。滑动性疝可以安全地使用 Lichtenstein 和腹腔镜技术进行治疗。
