目的 比较开放和腹腔镜手术修补复发性腹股沟疝的疗效，并分析影响术后并发症的危险因素。方法 回顾性分析2023年1—12月郑州大学第一附属医院、河南省人民医院、郑州市中心医院、许昌市中心医院和洛阳市中心医院收治的行无张力修补术的94例复发性腹股沟疝病人的临床资料。记录病人的疝环直径、疝位置、疝类型、修补方式、手术时间、尿潴留、切口感染、血肿、血清肿和住院时间等指标。随访内容包括疝复发、慢性疼痛、异物感和生活质量。结果 21例病人行开放手术，73例行腹腔镜手术。术后10例病人发生尿潴留，4例发生切口感染，5例发生血肿，6例发生血清肿。截至2025年3月，89例完成随访，其中复发4例，慢性疼痛8例，异物感14例，健康调查简表（SF-36）评分为24（21，26）分。前次术式为开放手术的病人65例，其中59例本次行腹腔镜疝修补术；前次行腹腔镜手术的病人24例，其中14例本次行开放手术。两次均行开放手术6例，两次均行腹腔镜手术10例，前者SF-36评分高于后者（P=0.042）。行腹腔镜手术与开放手术的复发性腹股沟疝病人的美国麻醉医师协会（ASA）分级比例、疝环直径、住院时间差异均有统计学意义（P<0.001、<0.001、=0.002）。单因素分析结果显示，对于复发性腹股沟疝病人，合并冠心病、良性前列腺增生（BPH）以及高龄是术后再复发的危险因素（P=0.012、0.021、0.043），双侧疝是术后发生慢性疼痛的危险因素（P=0.021），ASA分级低和围手术期发生血清肿是术后出现异物感的危险因素（P=0.021、<0.001）。多因素分析结果显示，血清肿是术后出现异物感的独立危险因素（OR=35.482，95%CI 3.491-360.585，P=0.003）。结论 腹腔镜手术与开放手术治疗复发性腹股沟疝的效果相近。对于高龄、合并冠心病和BPH的病人，须进行严密的评估与管理，降低复发风险；对于双侧疝病人，术后可采用多模式镇痛方案；应尽量避免血清肿的形成，以减少出现异物感。

Objective To compare outcomes of open and laparoscopic repair for recurrent inguinal hernia and identify risk factors of postoperative complications. Methods A retrospective analysis was conducted on the clinical data of 94 patients with recurrent inguinal hernia who underwent tension-free repair at The First Affiliated Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou Central Hospital, Xuchang Central Hospital and Luoyang Central Hospital between January and December 2023. Hernia defect diameter, hernia position, hernia type, repair method, operation time, urinary retention, wound infection, hematoma, seroma and hospital stay were recorded. Follow-up included hernia recurrence, chronic pain, foreign body sensation and quality of life. Results Twenty-one patients underwent open repair, and 73 patients underwent laparoscopic surgery. Postoperatively, urinary retention occurred in 10 patients, surgical site infection occurred in 4, hematoma occurred in 5, and seroma occurred in 6. Follow-up was completed on 89 patients, among whom 4 experienced recurrence, 8 had chronic pain, and 14 reported foreign body sensation. The 36-item short-form general survey questionnaire (SF-36) score was 24 (21, 26). Sixty-five patients had undergone open surgery previously, of whom 59 received laparoscopic repair in the current operation. Twenty-four patients had undergone laparoscopic surgery previously, of whom 14 underwent open surgery in the current operation. Six patients underwent open surgery twice, and 10 patients underwent laparoscopic surgery twice. The SF-36 score was significantly higher in patients who underwent laparoscopic surgery twice than in those who underwent open surgery twice (P=0.042). There were statistically significant differences between the laparoscopic and open surgery groups in the proportion of American Society of Anesthesiologists (ASA) physical status classification, hernia ring diameter and length of hospital stay（P<0.001、<0.001、=0.002）. Univariate analysis revealed that for patients with recurrent inguinal hernia, the presence of coronary heart disease, BPH and advanced age were risk factors for postoperative recurrence (P=0.012, 0.021, 0.043). Bilateral hernia was a risk factor for chronic postoperative pain (P=0.021), while lower ASA classification and the occurrence of seroma during the perioperative period were risk factors for postoperative foreign body sensation (P=0.021, <0.001). Multivariate analysis showed that seroma was an independent risk factor for postoperative foreign body sensation (OR=35.482, 95%CI 3.491-360.585, P=0.003). Conclusion The efficacy of laparoscopic surgery and open surgery in treating recurrent inguinal hernia is comparable. For elderly patients with comorbid coronary heart disease and BPH, thorough evaluation and management are required to reduce recurrence risk; bilateral hernia patients may benefit from multimodal analgesia postoperatively; measures should be taken to prevent seroma formation and minimize foreign body sensation.