Boudet M J, Perniceni T
Département Médico-Chirurgical de pathologie digestive, Institut Mutualiste Montsouris, Paris.
J Chir (Paris). 1998 May;135(2):57-64.
Efficacy of groin hernia repair is mainly evaluated by its recurrence rate. In the literature it depends on the type of surgery but also on the follow-up, which must last 5 years at least and has to be more than 90% complete. To acertain the clinical result, the patient must be examined by a surgeon. Among herniorraphies techniques, Shouldice procedure has the lowest recurrence rate. The Lichtenstein operation leads to less recurrence rate than McVay's, for mixt (direct and indirect) hernias. Post operative pain might be diminished after the former procedure. No randomized control trial has compared raphies and techniques involving a prosthesis, in groin hernia repair. Among laparoscopic techniques, the transabdominal and preperitoneal approaches have less recurrence rate than the entirely intra peritoneal one, which has been abandonned. Their recurrence rate is not different than recurrence rate of herniorraphies and techniques using a prosthesis. With them, post operative abdominal pain is diminished. Nevertheless no randomized control trial has demonstrated any superiority of laparoscopic techniques on the Shouldice procedure.
腹股沟疝修补术的疗效主要通过其复发率来评估。在文献中，这取决于手术类型，也取决于随访情况，随访必须至少持续5年且完成率必须超过90%。为确定临床结果，患者必须由外科医生进行检查。在疝修补技术中，Shouldice手术的复发率最低。对于混合性（直疝和斜疝）疝，Lichtenstein手术的复发率低于McVay手术。前一种手术后术后疼痛可能会减轻。在腹股沟疝修补术中，尚无随机对照试验比较使用补片的修补术和技术。在腹腔镜技术中，经腹和腹膜前入路的复发率低于完全腹膜内入路，后者已被摒弃。它们的复发率与使用补片的修补术和技术的复发率没有差异。采用这些技术，术后腹痛会减轻。然而，尚无随机对照试验证明腹腔镜技术优于Shouldice手术。
