Simons M P, Vos P M, van Geldere D, Hoitsma H F, Obertop H
Onze Lieve Vrouwe Gasthuis, afd. Heelkunde, Amsterdam.
Ned Tijdschr Geneeskd. 1996 Dec 14;140(50):2506-9.
To make an inventory of inguinal hernia repairs performed in one year, and to analyse the number of and origin of recurrent hernias.
Retrospective.
Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.
Analysis of all hernia operations performed in Amsterdam and Amstelveen in 1994 in male patients over 18 years of age. Request of national data, computer data from the hospitals, hand count of all operation reports and investigation of patient files.
In 1994, 1108 patients were operated for inguinal hernia on one or two sides. In 216/1108 (19.5%) cases recurrent hernia was involved. According to national statistics this occurred in 175/1123 (15.6%). In the two University hospitals 25.7% of all repairs were for a recurrent hernia, in the two hospitals with a surgical training programme this proportion was 17.9% and in the five hospitals without a training programme it was 18.6%. Of the early recurrences (within two years) 82.5% (47/57) were reoperated in the same hospital as before but of the late recurrences (more than 10 years) this proportion was only 26.8%. Only 16.6% (36/216) of the patients with a recurrence were reoperated by the same surgeon who had performed the prior operation. Most popular method for repair was a Bassini (59%). In the training hospitals more early recurrences were repaired than in the non-training hospitals.
The percentage of hernia repairs for recurrent hernia is higher than national statistics suggest and higher than expected. Surgeons have little insight into their performance as many recurrences are repaired by another surgeon and many recurrences occur after ten years. Better training and more use of modern techniques may improve results.
统计一年内腹股沟疝修补手术的情况，并分析复发性疝的数量及复发原因。
回顾性研究。
荷兰阿姆斯特丹的翁泽利夫弗劳韦加斯医院。
分析1994年在阿姆斯特丹和阿姆斯特尔芬为18岁以上男性患者进行的所有疝手术。索取国家数据、医院的计算机数据，手工清点所有手术报告并查阅患者档案。
1994年，1108例患者接受了单侧或双侧腹股沟疝手术。其中216/1108（19.5%）例为复发性疝。根据国家统计数据，这一比例为175/1123（15.6%）。在两家大学医院，所有修补手术中有25.7%是针对复发性疝，在两家设有外科培训项目的医院，这一比例为17.9%，在五家没有培训项目的医院，这一比例为18.6%。早期复发（两年内）的患者中，82.5%（47/57）在同一家医院再次手术，但晚期复发（超过10年）的患者中，这一比例仅为26.8%。复发患者中只有16.6%（36/216）由之前进行首次手术的同一位外科医生再次手术。最常用的修补方法是巴西尼法（59%）。培训医院修复的早期复发性疝比非培训医院多。
复发性疝修补手术的比例高于国家统计数据显示的比例，也高于预期。由于许多复发是由另一位外科医生修复的，而且许多复发发生在十年后，外科医生对自己的手术表现了解甚少。更好的培训和更多地使用现代技术可能会改善手术效果。
