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Shouldice 修补术后腹股沟疝复发手术的时间模式。

Temporal patterns for inguinal hernia recurrence operations after Shouldice Repair.

机构信息

Department of Surgery, Shouldice Hospital, 7750 Bayview Ave., Thornhill, ON, L3T 4A3, Canada.

Department of General and Visceral Surgery, University Hospital Brandenburg an der Havel, Brandenburg, Germany.

出版信息

Hernia. 2024 Apr;28(2):607-614. doi: 10.1007/s10029-023-02955-0. Epub 2024 Jan 27.

Abstract

PURPOSE

Shouldice Repair for inguinal hernias results in a low recurrence rate; however, little is known about the risk factors for these relapses. In the present study, we reviewed all patient's undergoing a reoperation for recurrence after a primary Shouldice Repair.

METHODS

Patients undergoing recurrent inguinal hernia repair from 2013 to 2017 were identified. The subgroup of patients with the first recurrence after a Shouldice Repair at this institution was selected and included. Data collection from the index and the reoperation surgery were performed, as well as statistical analysis.

RESULTS

A total of 125 patients were included in the analysis. The mean age was 50.8 ± 13.9 (body mass index: 24.6 ± 2.6 kg/m), 97% were male. The most common interval for a recurrence reoperation was in the first 5 years following the initial surgery (37.6% of patients; mode: 1 year; median: 7 years; mean: 13.7 ± 13.8 years). A temporal median pattern for recurrence reoperation according to age interval was noted (patients < 41 years old: 20 years; patients aged 41-60 years old: 10 years and patients > 61 years: 2 years)).

CONCLUSION

Patients undergoing reoperations for recurrent inguinal hernias after a primary Shouldice Repair presented a pattern of temporal recurrence according to age. Older patients present with earlier recurrences than younger ones, an important consideration in the assessment of patients postoperatively.

摘要

目的

Shouldice 修复术治疗腹股沟疝可降低复发率,但对于这些复发的危险因素知之甚少。本研究回顾了所有在我院行初次 Shouldice 修复术后复发再次手术的患者。

方法

确定了 2013 年至 2017 年期间接受复发性腹股沟疝修复术的患者。选择并纳入了该机构初次 Shouldice 修复术后首次复发的患者亚组。对索引手术和再次手术的数据进行了收集和统计分析。

结果

共有 125 例患者纳入分析。平均年龄为 50.8±13.9(体重指数:24.6±2.6 kg/m),97%为男性。复发再次手术的最常见间隔时间为初次手术后的前 5 年(37.6%的患者;模式:1 年;中位数:7 年;均值:13.7±13.8 年)。根据年龄间隔,注意到复发再次手术的时间中位数模式(<41 岁的患者:20 年;41-60 岁的患者:10 年;>61 岁的患者:2 年)。

结论

初次 Shouldice 修复术后复发腹股沟疝再次手术的患者,根据年龄呈现出复发的时间模式。老年患者比年轻患者更早复发,这是术后评估患者的一个重要考虑因素。

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