Shuttleworth Paul, Sabri Shariq, Mihailescu Andrei
Department of General Surgery, Tameside General Hospital, Tameside and Glossop Foundation Trust, Ashton-under Lyne, United Kingdom.
J Abdom Wall Surg. 2023 Apr 21;2:11217. doi: 10.3389/jaws.2023.11217. eCollection 2023.
Femoral hernias are a relatively rare type of hernia but have a high complication rate, with a high proportion either presenting as an emergency or requiring emergency management. Minimal access surgery has been shown to be safe, with good results, in an elective setting, but there is little published evidence of its utility in an emergency. A systematic review was conducted searching PubMed, OVID, Embase, and Cochrane reviews for ((Femoral hernia) AND (laparoscop* OR minimal access OR robotic)) AND (strangulat* OR obstruct* OR incarcerat*). 286 manuscripts were identified of which 33 were relevant. 24 were individual case reports, 3 case series, 4 cohort studies or case control series, and 2 high level reviews of National registers. Minimal access surgery can avoid an unnecessary laparotomy for the assessment of hernial contents, especially a TAPP approach. Minimal access repair of femoral hernias as an emergency is feasible and can be done safely with results similar to open surgery but good quality evidence is lacking.
股疝是一种相对罕见的疝，但并发症发生率高，其中很大一部分以急症形式出现或需要进行急诊处理。在择期手术中，微创手术已被证明是安全的，效果良好，但几乎没有已发表的证据表明其在急诊情况下的效用。我们进行了一项系统评价，在PubMed、OVID、Embase和Cochrane综述中检索（（股疝）且（腹腔镜或微创或机器人手术））且（绞窄或梗阻或嵌顿）。共识别出286篇手稿，其中33篇相关。24篇为个案报告，3篇为病例系列，4篇为队列研究或病例对照系列，2篇为国家登记册的高级别综述。微创手术可以避免为评估疝内容物而进行不必要的剖腹手术，尤其是经腹腹膜前修补（TAPP）方法。作为急诊手术，股疝的微创手术是可行的，并且可以安全进行，结果与开放手术相似，但缺乏高质量证据。
