Purpose

The primary goal of this study was to determine the incidence of occult paraumbilical hernias during open primary umbilical hernia repair. The secondary objective was to further characterize the clinical features of these patients and hernias.

Methods

This was a retrospective chart review of patients undergoing primary umbilical hernia repair at Shouldice Hospital, from 2007 to 2017. Inclusion criteria were utilized to elucidate patients, where a concomitant occult paraumbilical hernia was found. Descriptive statistics were used throughout.

Results

5850 patients underwent primary umbilical hernia repair, 459 (7.85%) patients had concomitant primary umbilical and paraumbilical hernias. There was a preoperative suspicion/diagnosis of a paraumbilical hernia in 166 (2.8%) of these patients. In 293 (5.01%) patients who had open primary umbilical hernia repair, at least one associated occult paraumbilical defect was found during surgery. Most of umbilical and concomitant occult paraumbilical hernias were small and medium size defects. The great majority of the reported occult paraumbilical hernias were found in the supraumbilical position at a distance of 3 cm or less from the top of the umbilical defect.

Conclusion

The incidence of concomitant occult paraumbilical hernias in patients mildly overweight undergoing primary umbilical hernia repair is 5.01%, relevant to surgical decision-making. Since the great majority of these paraumbilical defects are superior to the umbilical defect, an adequate incision and dissection for at least 3 cm above the umbilical hernia may reduce the number of missed concomitant hernias and result in less presumed recurrences.

中文翻译：

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原发性脐疝修补术患者隐匿性脐旁疝的发生率

目的

本研究的主要目的是确定开放性原发性脐疝修补术中隐匿性脐旁疝的发生率。次要目标是进一步描述这些患者和疝气的临床特征。

方法

这是对 2007 年至 2017 年在 Shouldice 医院接受原发性脐疝修复的患者的回顾性图表回顾。使用纳入标准来阐明患者，其中发现了伴随的隐匿性脐旁疝。自始至终都使用了描述性统计数据。

结果

5850 例患者接受了原发性脐疝修补术，459 例（7.85%）患者同时患有原发性脐疝和脐旁疝。这些患者中有 166 名（2.8%）在术前怀疑/诊断为脐旁疝。在进行开放性原发性脐疝修补术的 293 例（5.01%）患者中，在手术过程中发现了至少一个相关的隐匿性脐旁缺损。大多数脐部和伴随的隐匿性脐旁疝是中小型缺陷。绝大多数报告的隐匿性脐旁疝发生在距脐缺损顶部3厘米或更短的脐上位置。

结论

轻度超重接受原发性脐疝修补术的患者并发隐匿性脐疝的发生率为 5.01%，与手术决策有关。由于绝大多数这些脐旁缺陷优于脐部缺陷，因此在脐疝上方至少 3 cm 处进行适当的切口和解剖可以减少漏诊的伴随疝的数量，并导致更少的假定复发。