First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma Str., ZIP Code 11527, Athens, Athens, Greece.
Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Aretaieion Hospital, Athens, Greece.
Langenbecks Arch Surg. 2024 Jul 29;409(1):230. doi: 10.1007/s00423-024-03427-4.
Spigelian Hernia (SH) is characterized by the protrusion of abdominal viscera or preperitoneal fat through a defect in the spigelian aponeurosis. The objective of this systematic review was to evaluate current literature on Spigelian Hernias in adult population and elucidate their characteristics and preferable management.
MEDLINE and Scopus bibliographical databases were systematically searched (last search: 31st January 2024) for studies concerning SHs.
Two hundred and thirty-four articles met predefined inclusion criteria and concerned collectively 1,629 patients with SHs (58.7% females) with an age of 62.32 ± 17.71 (mean ± SD) years and a BMI of 28.56 ± 7.34 (mean ± SD) kg/m2. A minimally invasive approach was opted at 46.8% of cases, while a mesh was implemented at 67.9% of cases. Postoperative length of hospital stay was 2.8 ± 2.9 (mean ± SD) days. Following individual cases analysis, open surgery was preferable at emergency setting (OR: 2.45; 95% CI: 1.36-4.41; p-value: 0.003), and minimally invasive approaches were associated with shorter length of hospital stay [2 (1-9) vs. 5 (1-22) days; p-value: <0.001]. Overall, thirty-day postoperative morbidity and mortality rates reached 7.0% and 0.3% respectively.
SH is a rare ventral hernia, and it concerns most frequently overweight women. Open surgical approach is preferred in emergency cases, while laparoscopic surgery is associated with shorter hospitalization. Further comparative studies are necessary to determine optimal surgical approach.
Spigelian 疝（SH）的特征是腹部内脏或腹膜前脂肪通过腱膜 Spigelian 缺损突出。本系统评价的目的是评估成人 Spigelian 疝的现有文献，并阐明其特征和首选治疗方法。
系统检索了 MEDLINE 和 Scopus 文献数据库（最后检索日期：2024 年 1 月 31 日），以获取有关 SH 的研究。
234 篇文章符合预先设定的纳入标准，共涉及 1629 例 SH 患者（58.7%为女性），年龄为 62.32±17.71（均数±标准差）岁，BMI 为 28.56±7.34（均数±标准差）kg/m2。46.8%的病例采用微创方法，67.9%的病例采用网片。术后住院时间为 2.8±2.9（均数±标准差）天。通过对个别病例的分析，在紧急情况下开放手术更为可取（OR：2.45；95%CI：1.36-4.41；p 值：0.003），而微创方法与较短的住院时间相关[2（1-9）天与 5（1-22）天；p 值：<0.001]。总体而言，术后 30 天的发病率和死亡率分别为 7.0%和 0.3%。
SH 是一种罕见的腹侧疝，最常发生在超重女性中。在紧急情况下，开放手术是首选方法，而腹腔镜手术与较短的住院时间相关。需要进一步的比较研究来确定最佳手术方法。
