Results of Shouldice hernia repair after 18 years of follow-up in all the patients

被引:9
作者
Martin Duce, A. [1 ,2 ]
Lozano, O. [3 ]
Galvan, M. [3 ]
Muriel, A. [1 ,4 ]
Villeta, S. [1 ]
Gomez, J. [1 ]
机构
[1] Univ Alcala De Henares, Fac Med & Hlth Sci, Plaza San Diego S-N, Madrid 28801, Spain
[2] Principe Asturias Univ Hosp, Dept Gen Surg, Madrid, Spain
[3] Arcos Mar Menor Univ Hosp, Dept Gen Surg, San Javier, Spain
[4] Ramon y Cajal Univ Hosp, Inst Ramon y Cajal Invest Sanitaria, Biostat Dept, IRYCIS,CIBERESP, Madrid, Spain
关键词
Inguinal hernia; Shouldice repair; Quality of follow-up; Postoperative pain; INGUINAL-HERNIA; GENERAL-ANESTHESIA; CONTROLLED TRIAL; CHRONIC PAIN; RECURRENCE; ADULT; HERNIORRHAPHY; COMPLICATIONS; LONG;
D O I
10.1007/s10029-021-02422-8
中图分类号
R61 [外科手术学];
学科分类号
摘要
Purpose Evaluate the long-term efficacy of the Shouldice technique performed by non-specialized surgeons and also to reflex on the quality parameters necessary to safely assess hernia recurrence rates. Methods During 3 years, a prospective study was conducted in 243 adult men who underwent surgery for primary inguinal hernias by 13 junior surgeons with an interest in hernia surgery. Using local anesthesia, a classic 4 step Shouldice repair, with polypropylene or polyester, was performed. All patients were followed for 18 years. The follow-up met the nine quality criteria proposed by the authors. Results At 18 years, 80.2% of patients were followed and only 6.5% were lost. There were 7 recurrences in the first 10 years, 5 of them secondary to a direct hernia, and the same after 18 years. The recurrence rate was 2.88%. Tolerance of the local anesthesia was excellent in 91.4%of patients and, after 3 years, the pain was considered moderate or severe in 4 patients (1.8%). Conclusions It is necessary to incorporate more demanding criteria in the assessment of recurrence, to give more valid results. The Shouldice technique remains a useful technique today not only in patients under 30 years of age, and in the absence of risk factors, but also in cases of intolerance, patient rejection or absence of mesh. In addition, it provides the clinical and economic advantages of being possible to perform it under local anesthesia.
引用
收藏
页码:1215 / 1222
页数:8
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