Importance To our knowledge, a systematic review has not yet been performed that specifically addresses the management of inguinal hernia in women. Recurrence after repair of inguinal hernia is not unusual in women and may be a previously undiagnosed femoral hernia, which is rarely seen in men.

Objective To investigate rates and types of recurrences in women who had undergone repair of primary inguinal hernia.

Evidence Review PubMed, Embase, and the Cochrane databases were searched in September 2017 for studies reporting recurrences after repair of primary inguinal hernia in women. Crude rates of recurrence (number of recurrences/number of women) were calculated after open and laparoscopic repairs, and the type of recurrent hernia was registered, if noted in the studies. This review is reported according to the PRISMA guideline.

Findings A total of 55 studies were included, comprising 43 870 women (mean age, 42-69 years; median age, 57 years). Five studies were randomized clinical trials, 14 were prospective cohort studies, 7 were prospective database studies, and 29 were retrospective cohort studies. Twenty studies reported recurrence after laparoscopic repair, with a crude recurrence rate of 1.2% (27 of 2257) (range, 0%-5%) and a median follow-up of 24 months. Thirty-seven studies reported open repair, with a crude recurrence rate of 2.4% (818 of 33 971) (range, 0%-12.5%) and a median follow-up of 36 months. The crude recurrence rate in randomized clinical trials and prospective studies was 1.2% (18 of 1525) after laparoscopic repair compared with 4.9% (490 of 10 058) after open repair. The recurrent inguinal hernia was a femoral hernia in 203 of 496 patients (40.9%) after open repair, compared with 0% of patients after laparoscopic repair. Recurrence rates were similar when open mesh vs nonmesh techniques were used.

Conclusions and Relevance Recurrence rates after repair of primary inguinal hernia in women are lower after laparoscopic repair compared with open repair. Intraoperative findings during repair of recurrent inguinal hernia are often femoral hernias in women.

重要性 据我们所知，尚未进行专门针对女性腹股沟疝处理的系统评价。腹股沟疝修补后的复发在女性中并不罕见，并且可能是以前未被诊断的股疝，在男性中很少见。

目的 探讨原发性腹股沟疝修补术妇女的复发率和复发类型。

证据审查 2017年9月对PubMed，Embase和Cochrane数据库进行了检索，以研究报告女性原发性腹股沟疝修复后复发的研究。如果在研究中注明，则在开腹和腹腔镜修复后计算粗略的复发率（复发次数/妇女人数），并记录复发疝的类型。根据PRISMA指南报告了该评价。

发现 总共包括55项研究，包括43 870名妇女（平均年龄42-69岁；中位年龄57岁）。5项研究为随机临床试验，14项为前瞻性队列研究，7项为前瞻性数据库研究，29项为回顾性队列研究。二十项研究报告了腹腔镜修复后的复发，粗术后复发率为1.2％（2257例中的27例）（范围为0％-5％），中位随访时间为24个月。37项研究报告了开放性修复，粗复发率2.4％（818例，共33 971例）（范围：0％-12.5％），中位随访36个月。在随机临床试验和前瞻性研究中，腹腔镜修复后的粗略复发率为1.2％（1525年中的18），而开放式修复后为4.9％（10058中的490）。复发性腹股沟疝是496例患者中的203例股骨疝（40。开腹修复后为9％），而腹腔镜修复后为0％。当使用开放网格与非网格技术时，复发率相似。

结论与相关 性腹腔镜修补术后女性原发性腹股沟疝的术后复发率比开放修补术低。复发性腹股沟疝修补期间的术中发现通常为女性股骨疝。