Accuracy of clinical diagnosis of inguinal and femoral hernia and its usefulness for indicating laparoscopic surgery
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The preoperative diagnosis of inguinal hernias is one of the surgeon's most commonplace duties yet one of the least valued aspects in the treatment of this pathology. The introduction of the laparoscopic technique for inguinal hernia repair may stimulate an interest in this problem. The aim of the study is to analyse the diagnostic accuracy of clinical examination of inguinal and femoral hernias. 278 patients with a possible inguinal and femoral hernia received from the same surgeon a thorough clinical examination and preoperative diagnosis of the type of hernia (indirect or direct inguinal, and femoral). The data obtained were compared to the intra-operative findings. The influence of age, sex and site was studied with regard to the sensitivity of the clinical diagnosis. Direct inguinal hernias accounted for 35% of the total. Indirect inguinal hernias were diagnosed more accurately (85%) than direct (64%) and femoral (39%) hernias. Clinical diagnosis was not influenced by age, sex or site of the femoral hernia. Statistically significant differences were revealed only for inguinal hernias in the group of patients aged over 50 years and with a unilateral site (p<0.05). Thorough physical exploration should never be underrated in the diagnosis of inguinal hernias as it may help classify hernias with great accuracy.
Key wordsInguinal hernia Diagnosis Laparoscopy Surgery
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- Bégin GF (1997) Laparoscopic treatment of inguinal hernia through the extraperitoneal route. Eur J Coelio-Surg 1: 10–14Google Scholar
- Champault G, Barrat C, Catheline JM, Rizh N (1998) Four year results of two randomised prospective studies comparing the Shouldice operation and the Stoppa procedure using a totally pre-peritoneal laparoscopic approach (461 patients). Hernia 2: 19–23Google Scholar
- Devlin HB (1988) Management of abdominal hernias. London, Butterworths, pp 105Google Scholar
- Moreno-Egea A, Perez-Abad JM, Aguayo JL (1999) Resultados de un programa inicial en cirugía laparoscópica totalmente extraperitoneal para el tratamiento de la hernia inguinal. Cir Esp 65(2): 139–142Google Scholar
- Moreno-Egea, Aguayo JL (1999) Se puede incluir la técnica laparoscópica extraperitoneal para el tratamiento de la hernia inguinal en un programa de cirugía mayor ambulatoria sin ingreso? Cir Esp 66(6) (in press)Google Scholar
- Moreno-Egea A, Torralba JA, Perez-Abad JM, Aguayo JL (1998) Extraperitoneal laparoscopic hernia repair for indirect inguinal hernia: anatomy of nerve lesions. Video Review Surg 15(1): 37–44Google Scholar
- Read RC (1994) Collagen synthesis and direct inguinal herniation. In: Arregui ME, Nagan RF (eds). Inguinal hernia. Advances or controversies? Radcliffe Medical Press, New York, pp 61–64Google Scholar
- Stoppa R (1998) Hernia of the abdominal wall. In: Chevrel JP (ed) Hernias and surgery of the abdominal wall. Springer, Berlin, pp 175–178Google Scholar
- Truong SN, Pfingsten F, Dreuw B, Schumpelick V (1995) Value of ultrasound in the diagnosis of undetermined findings in the abdominal wall and inguinal region. In: Schumpelick V, Wantz GE (eds). Inguinal hernia repair. Expert Meeting on hernia Surgery, ST Moritz 1994. Karger, Basel pp 29–41Google Scholar