Postlethwait R W
Ann Surg. 1985 Dec;202(6):777-9. doi: 10.1097/00000658-198512000-00019.
An analysis of 584 operations for recurrent inguinal hernia was made in an attempt to determine the cause of the recurrence based on the anatomic findings. The recurrence was indirect in 300, direct in 241, and various other in 43 operations. The causes of the indirect recurrences appeared to be an unrecognized hernia, incomplete dissection or improper ligation of the sac, failure to narrow the cord, or inadequate reconstruction of the internal ring. No cause for the diffuse direct recurrences was apparent. Of the 241 hernias in Hesselbach's triangle, 144 were small localized defects, usually (112) just lateral to the symphysis. These were considered to be caused by the cutting action of a suture placed under tension. On the basis of these findings, suggestions are made for primary inguinal hernia operations.
对584例复发性腹股沟疝手术进行了分析，试图根据解剖学发现确定复发原因。300例复发为间接性，241例为直接性，43例手术为其他各种类型。间接复发的原因似乎是未识别出的疝、疝囊解剖不完全或结扎不当、未能缩小精索、或内环重建不足。弥漫性直接复发的原因不明显。在海氏三角的241例疝中，144例为小的局限性缺损，通常（112例）位于耻骨联合外侧。这些被认为是由张力下放置的缝线的切割作用引起的。基于这些发现，对原发性腹股沟疝手术提出了建议。
