Tam Yuk Him, Lee Kim Hung, Sihoe Jennifer Dart Yin, Chan Kin Wai, Wong Pui Yiu, Cheung Sing Tak, Mou Jennifer Wai Cheung
Division of Paediatric Surgery & Paediatric Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
J Pediatr Surg. 2009 Aug;44(8):1502-5. doi: 10.1016/j.jpedsurg.2008.10.071.
The relatively high recurrence rate reported in laparoscopic hernia repair in children using intracorporeal suturing technique remains a concern. We aimed to investigate the effectiveness of the hook method during hernia repair that allows extraperitoneal passage of suture to close the hernia sac without creating any tension or skip areas and does not require laparoscopic suturing skills.
A retrospective review was conducted on 433 consecutive children who underwent laparoscopic hernia repair using the hook method by 1 of 4 surgeons from July 2004 to June 2007.
A total of 572 successful laparoscopic hernia repairs were performed among the 433 children with an age range of 1 week to 15 years (mean = 56 months). Conversion rate was 1.04%. Contralateral patent processus vaginalis was found in 26.8%. Mean operating time was 23.8 and 40.2 minutes for unilateral and bilateral repair, respectively. At a median follow-up of 20 months, there were 2 recurrences (0.35%), 2 hydroceles, 1 ascending testis, and 1 instance of testicular atrophy. No serious complications were associated with the procedure.
Medium-term results suggest that laparoscopic hernia repair with the hook method is a sound alternative to open herniotomy in children.
儿童腹腔镜疝修补术中采用体内缝合技术报告的相对较高的复发率仍然是一个问题。我们旨在研究疝修补术中钩法的有效性，该方法允许缝线经腹膜外穿过以闭合疝囊，不会产生任何张力或遗漏区域，并且不需要腹腔镜缝合技术。
对2004年7月至2007年6月期间由4位外科医生中的1位使用钩法进行腹腔镜疝修补术的433例连续儿童进行回顾性研究。
433例年龄在1周至15岁（平均56个月）的儿童共进行了572例成功的腹腔镜疝修补术。中转率为1.04%。对侧鞘突未闭发生率为26.8%。单侧和双侧修补的平均手术时间分别为23.8分钟和40.2分钟。中位随访20个月时，有2例复发（0.35%）、2例鞘膜积液、1例睾丸上升和1例睾丸萎缩。该手术未出现严重并发症。
中期结果表明，儿童腹腔镜疝修补术中采用钩法是开放疝修补术的一种可靠替代方法。
