Primatesta P, Goldacre M J
Department of Public Health and Primary Care, University of Oxford, UK.
Int J Epidemiol. 1996 Aug;25(4):835-9. doi: 10.1093/ije/25.4.835.
Inguinal hemia repair is one of the most common operations undertaken in routine surgical practice. It generally carries a very low risk of major adverse sequelae. We analysed profiles, separately, for elective and emergency operations to report on the incidence and major adverse outcomes of inguinal hernia repair in a geographically defined population.
Age- and sex-specific hospital admission rates, emergency readmission rates within 30 days of discharge, and mortality rates, separately for elective and emergency operations, were calculated for the period 1976-1986 in the Oxford Record Linkage Study (ORLS) area.
In all, 30,675 inguinal hernia repairs were performed in the area, an all-ages annual incidence of 13 per 10,000 population. Some 9% of patients underwent operation in an emergency admission. Elective operation rates remained constant over time. Emergency repairs decreased significantly over time in males. Patients who underwent emergency repair were older, had higher emergency readmission rates than those undergoing elective repair, and had significantly elevated postoperative mortality rates. In those who died it was uncommon for inguinal hernia to be recorded on their death certificates. Of the operations, 91% were undertaken on males; age-specific rates were highest in infants and the elderly; and emergency operation rates rose exponentially with age in people > 50 years.
The lifetime 'risk' of inguinal hernia repair is high: at currently prevailing rates we estimate it at 27% for men and 3% for women. There is significant elevation of mortality after emergency operations. Elective repair of inguinal hernia should be undertaken soon after the diagnosis is made to minimize the risk of adverse outcomes.
腹股沟疝修补术是常规外科手术中最常见的手术之一。一般而言，其发生严重不良后遗症的风险极低。我们分别分析了择期手术和急诊手术的情况，以报告在一个特定地理区域内腹股沟疝修补术的发病率及主要不良后果。
在牛津记录链接研究（ORLS）区域，计算了1976年至1986年期间按年龄和性别划分的住院率、出院后30天内的急诊再入院率以及死亡率，分别针对择期手术和急诊手术。
该区域共进行了30675例腹股沟疝修补术，全年龄段年发病率为每10000人中有13例。约9%的患者在急诊入院时接受手术。择期手术率随时间保持稳定。男性急诊手术率随时间显著下降。接受急诊修补的患者年龄较大，急诊再入院率高于接受择期修补的患者，术后死亡率也显著升高。在死亡患者中，腹股沟疝很少被记录在死亡证明上。手术患者中91%为男性；特定年龄发病率在婴儿和老年人中最高；50岁以上人群的急诊手术率随年龄呈指数上升。
腹股沟疝修补术的终生“风险”很高：按照目前的流行率，我们估计男性为27%，女性为3%。急诊手术后死亡率显著升高。腹股沟疝诊断后应尽快进行择期修补，以将不良后果风险降至最低。
