Paul A, Troidl H, Williams J I, Rixen D, Langen R
Second Department of Surgery, University of Cologne, Germany.
Br J Surg. 1994 Oct;81(10):1531-4. doi: 10.1002/bjs.1800811045.
Between 1986 and 1992, 265 men of mean age 51 (range 16-75) years with a primary inguinal hernia were randomized to undergo surgery by staff surgeon or surgical resident and further randomized to receive a modified Bassini operation (transversalis fascia not divided but included in the repair) or Shouldice procedure. The follow-up rate was 92.1 per cent with a mean follow-up of 3.3 years. Recurrence developed in 12 of 125 patients with a Bassini procedure and two of 119 after a Shouldice repair (9.6 versus 1.7 per cent, P = 0.006). The recurrence rate was no different for staff surgeons and trainees (5.9 versus 5.6 per cent, P not significant). Multivariate analysis identified the presence of a direct hernia (P = 0.003) as the additional main factor for the development of recurrence.
1986年至1992年间，265名平均年龄51岁（范围16 - 75岁）的原发性腹股沟疝男性患者被随机分配，由外科主治医师或住院医师进行手术，并进一步随机接受改良Bassini手术（不切开腹横筋膜但将其纳入修补）或Shouldice手术。随访率为92.1%，平均随访时间为3.3年。125例行Bassini手术的患者中有12例复发，119例行Shouldice修补术后有2例复发（9.6%对1.7%，P = 0.006）。外科主治医师和实习医生的复发率无差异（5.9%对5.6%，P无统计学意义）。多因素分析确定存在直疝（P = 0.003）是复发的另一个主要因素。
