Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
Department of Life, Health & Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Surg Innov. 2024 Oct;31(5):555-562. doi: 10.1177/15533506241273398. Epub 2024 Aug 3.
Femoral hernia accounts for 22% of groin hernia operations in women and for 1.1% in men. Numerous surgical approaches have been reported but there is no consensus. Many of the recurrence rates are reported in old literature, while recent reports are scarce. The aim of the present study was to review rates of recurrences in patients who underwent open repair of a primary femoral hernia.
We conducted a systematic search in the electronic literature, using the search terms "femoral hernia" and "recurrence". We included studies published from 2002 that had as primary or secondary endpoint to evaluate the recurrence after surgery. Risk of bias was assessed by the Cochrane risk of bias tool for RCT and by the Newcastle-Ottawa Scale for cohort studies.
Fifteen eligible articles were included in our systematic review. A total of 1087 procedures were performed according to the defined criteria. The metanalytic evaluation highlighted a higher probability of recurrence for non-mesh than mesh repairs (6.5% vs 1.9%; RR 0.924, 95% CI: 0.857 - 0.996). In patients treated in emergency settings the rate of recurrences was 3.7%; in patients who received elective repairs it was 0.71%. Six studies reported that most of recurrences occurred within the first post-operative year.
We found that crude recurrence rate after open repair of a primary femoral hernia is about 4%. This rate is higher in case of non-mesh techniques and in emergency surgery. Our results support the recommendation that femoral hernias should be repaired with mesh techniques.
女性股疝占腹股沟疝手术的 22%，男性占 1.1%。有许多手术方法被报道，但没有共识。许多复发率是在旧文献中报道的，而最近的报道很少。本研究旨在回顾行原发性股疝开放修补术患者的复发率。
我们在电子文献中使用“股疝”和“复发”这两个检索词进行了系统搜索。我们纳入了 2002 年以来发表的研究，这些研究的主要或次要终点是评估手术后的复发情况。使用 Cochrane 偏倚风险工具评估 RCT 的偏倚风险，使用纽卡斯尔-渥太华量表评估队列研究的偏倚风险。
我们的系统综述共纳入了 15 篇符合条件的文章。根据既定标准，共有 1087 例手术。荟萃分析结果表明，非网片修补术比网片修补术更易复发（6.5%比 1.9%；RR 0.924，95%CI：0.857-0.996）。在急诊治疗的患者中，复发率为 3.7%；在择期手术的患者中，复发率为 0.71%。有 6 项研究报告称，大多数复发发生在术后 1 年内。
我们发现，原发性股疝开放修补术后的粗复发率约为 4%。在非网片技术和急诊手术中，复发率更高。我们的研究结果支持股疝应采用网片技术修补的建议。
