Abstract：
OBJECTIVE: Femoral hernia accounts for 22% of groin hernia operations in women and for 1.1% in men. Numerous surgical approaches have been reported but there is no consensus. Many of the recurrence rates are reported in old literature, while recent reports are scarce. The aim of the present study was to review rates of recurrences in patients who underwent open repair of a primary femoral hernia.
METHODS: We conducted a systematic search in the electronic literature, using the search terms \"femoral hernia\" and \"recurrence\". We included studies published from 2002 that had as primary or secondary endpoint to evaluate the recurrence after surgery. Risk of bias was assessed by the Cochrane risk of bias tool for RCT and by the Newcastle-Ottawa Scale for cohort studies.
RESULTS: Fifteen eligible articles were included in our systematic review. A total of 1087 procedures were performed according to the defined criteria. The metanalytic evaluation highlighted a higher probability of recurrence for non-mesh than mesh repairs (6.5% vs 1.9%; RR 0.924, 95% CI: 0.857 - 0.996). In patients treated in emergency settings the rate of recurrences was 3.7%; in patients who received elective repairs it was 0.71%. Six studies reported that most of recurrences occurred within the first post-operative year.
CONCLUSIONS: We found that crude recurrence rate after open repair of a primary femoral hernia is about 4%. This rate is higher in case of non-mesh techniques and in emergency surgery. Our results support the recommendation that femoral hernias should be repaired with mesh techniques.
METHODS: We conducted a systematic search in the electronic literature, using the search terms \"femoral hernia\" and \"recurrence\". We included studies published from 2002 that had as primary or secondary endpoint to evaluate the recurrence after surgery. Risk of bias was assessed by the Cochrane risk of bias tool for RCT and by the Newcastle-Ottawa Scale for cohort studies.
RESULTS: Fifteen eligible articles were included in our systematic review. A total of 1087 procedures were performed according to the defined criteria. The metanalytic evaluation highlighted a higher probability of recurrence for non-mesh than mesh repairs (6.5% vs 1.9%; RR 0.924, 95% CI: 0.857 - 0.996). In patients treated in emergency settings the rate of recurrences was 3.7%; in patients who received elective repairs it was 0.71%. Six studies reported that most of recurrences occurred within the first post-operative year.
CONCLUSIONS: We found that crude recurrence rate after open repair of a primary femoral hernia is about 4%. This rate is higher in case of non-mesh techniques and in emergency surgery. Our results support the recommendation that femoral hernias should be repaired with mesh techniques.
摘要：
目的：股骨疝占女性腹股沟疝手术的22%，男性占1.1%。已经报道了许多手术方法，但没有达成共识。许多复发率在旧文献中都有报道，虽然最近的报道很少。本研究的目的是审查接受原发性股疝开放修复的患者的复发率。
方法：我们在电子文献中进行了系统的搜索，使用搜索词“股疝”和“复发”。我们纳入了2002年发表的以评估手术后复发为主要或次要终点的研究。通过用于RCT的Cochrane偏倚风险工具和用于队列研究的纽卡斯尔-渥太华量表评估偏倚风险。
结果：15篇符合条件的文章纳入我们的系统评价。根据定义的标准进行总共1087次手术。元分析评估强调了非网孔的复发概率高于网孔修复（6.5％vs1.9％；RR0.924，95％CI：0.857-0.996）。在紧急情况下接受治疗的患者中，复发率为3.7％；在接受选择性修复的患者中为0.71％。六项研究报告说，大多数复发发生在术后第一年。
结论：我们发现原发性股疝开放修补术后的粗复发率约为4%。在非网状技术和紧急手术的情况下，该比率更高。我们的结果支持建议使用网状技术修复股疝。
方法：我们在电子文献中进行了系统的搜索，使用搜索词“股疝”和“复发”。我们纳入了2002年发表的以评估手术后复发为主要或次要终点的研究。通过用于RCT的Cochrane偏倚风险工具和用于队列研究的纽卡斯尔-渥太华量表评估偏倚风险。
结果：15篇符合条件的文章纳入我们的系统评价。根据定义的标准进行总共1087次手术。元分析评估强调了非网孔的复发概率高于网孔修复（6.5％vs1.9％；RR0.924，95％CI：0.857-0.996）。在紧急情况下接受治疗的患者中，复发率为3.7％；在接受选择性修复的患者中为0.71％。六项研究报告说，大多数复发发生在术后第一年。
结论：我们发现原发性股疝开放修补术后的粗复发率约为4%。在非网状技术和紧急手术的情况下，该比率更高。我们的结果支持建议使用网状技术修复股疝。
