Kald A, Nilsson E, Anderberg B, Bragmark M, Engström P, Gunnarsson U, Haapaniemi S, Lindhagen J, Nilsson P, Sandblom G, Stubberöd A
Department of Surgery at the University of Linköping, Sweden.
Eur J Surg. 1998 Jan;164(1):45-50. doi: 10.1080/110241598750004940.
Analysis of reoperation and recurrence rates three years after repair of groin hernias.
Prospective audit by questionnaire and selective follow-up.
Eight Swedish hospitals.
All groin hernia operations done during 1992 on patients between the ages of 15 and 80 years.
Postoperative complications, reoperation for recurrence, and recurrence.
During 1992, 1565 hernia operations were done. The postoperative complication rate was 8% (125/1565). At 36 months postoperatively 108 recurrences had already been reoperated on, six patients with recurrences were on the waiting list for reoperation and a further 36 recurrences had been detected at follow-up. The interhospital variation in recurrence rate ranged from 3% to 20%. Postoperative complications, recurrent hernia, direct hernia and hospital catchment area over 100000 inhabitants were all factors associated with an increased relative risk of recurrence.
The recurrence rate exceeded the reoperation rate for recurrence by almost 40% which should be taken into account if the reoperation rate is used as the endpoint after repairs of groin hernia. An audit scheme, based on prospective recording, reoperation rate, and (periodic) calculation of the recurrence rate may be used to identify risk factors for recurrence and areas in need of improvement.
分析腹股沟疝修补术后三年的再次手术率和复发率。
通过问卷调查和选择性随访进行前瞻性审计。
瑞典八家医院。
1992年对年龄在15至80岁之间的患者进行的所有腹股沟疝手术。
术后并发症、复发再次手术以及复发情况。
1992年共进行了1565例疝手术。术后并发症发生率为8%（125/1565）。术后36个月时，已有108例复发患者接受了再次手术，6例复发患者在等待再次手术，另有36例复发在随访中被发现。各医院之间的复发率差异在3%至20%之间。术后并发症、复发性疝、直疝以及居民人口超过10万的医院服务区域均是复发相对风险增加的相关因素。
复发率比复发再次手术率高出近40%，如果将再次手术率作为腹股沟疝修补术后的终点指标，这一点应予以考虑。基于前瞻性记录、再次手术率以及（定期）复发率计算的审计方案可用于识别复发的风险因素和需要改进的领域。
