Choi Mi Jeong, Lee Kang-Seok, Oh Heung-Kwon, Ahn Sang-Hoon, Ahn Hong-Min, Shin Hye-Rim, Lee Tae-Gyun, Jo Min Hyeong, Kim Duck-Woo, Kang Sung-Bum
Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Ann Surg Treat Res. 2024 Jun;106(6):330-336. doi: 10.4174/astr.2024.106.6.330. Epub 2024 May 30.
Managing recurrent inguinal hernias is complex, and choosing the right surgical approach (laparoscopic open) is vital for patient outcomes. This study compared the outcomes of using the same different surgical approaches for initial and subsequent hernia repairs.
We retrospectively analyzed patients who underwent recurrent inguinal hernia repair at Seoul National University Bundang Hospital between January 2014 and May 2023. Patients were divided into the "concordant" and "discordant" groups, comprising patients who underwent same and different approaches in both surgeries, respectively. Preoperative baseline characteristics, index surgery data, postoperative outcomes, and recurrence rates were analyzed and compared.
In total, 131 patients were enrolled; the concordant and discordant groups comprised 31 (open, n = 19; laparoscopic, n = 12) and 100 patients (open to laparoscopic, n = 68; laparoscopic to open, n = 32), respectively. No significant differences were observed in the mean operation time (50.5 ± 21.7 minutes 50.2 ± 20.0 minutes, P = 0.979), complication rates (6.5% 14.0%, P = 0.356), or 36-month cumulative recurrence rates (9.8% 9.8%; P = 0.865). The mean postoperative hospital stay was significantly shorter in the discordant than in the concordant group (1.8 ± 0.7 1.4 ± 0.6, P = 0.003).
Most recurrent inguinal hernia repairs were performed using the discordant surgical approach. Overall, concordance in the surgical approach did not significantly affect postoperative outcomes. Therefore, the selection of the surgical approach based on the patient's condition and surgeon's preference may be advisable.
复发性腹股沟疝的治疗较为复杂，选择正确的手术方式（腹腔镜手术或开放手术）对患者的治疗效果至关重要。本研究比较了初次和后续疝修补术采用相同或不同手术方式的治疗效果。
我们回顾性分析了2014年1月至2023年5月在首尔国立大学盆唐医院接受复发性腹股沟疝修补术的患者。患者分为“一致”组和“不一致”组，分别包括两次手术采用相同和不同手术方式的患者。分析并比较术前基线特征、首次手术数据、术后结果和复发率。
共纳入131例患者；“一致”组和“不一致”组分别有31例（开放手术，n = 19；腹腔镜手术，n = 12）和100例患者（从开放手术转为腹腔镜手术，n = 68；从腹腔镜手术转为开放手术，n = 32）。平均手术时间（50.5±21.7分钟对50.2±20.0分钟，P = 0.979）、并发症发生率（6.5%对14.0%，P = 0.356）或36个月累积复发率（9.8%对9.8%；P = 0.865）均无显著差异。“不一致”组的平均术后住院时间明显短于“一致”组（1.8±0.7对1.4±0.6，P = 0.003）。
大多数复发性腹股沟疝修补术采用了不一致的手术方式。总体而言，手术方式的一致性对术后结果没有显著影响。因此，根据患者情况和外科医生的偏好选择手术方式可能是明智的。
