Department of Pediatric Surgery, King Edward Memorial Hospital, Parel, Mumbai, India.
J Pediatr Surg. 2010 Apr;45(4):789-92. doi: 10.1016/j.jpedsurg.2009.08.007.
BACKGROUND/PURPOSE: A retrospective analysis of prospectively collected data of pediatric patients that underwent laparoscopic inguinal hernia repair.
A retrospective review was performed of the prospectively collected data of 576 laparoscopic internal ring closures in 437 children (age, 30 days-11 years; median, 1.9 years) from June 1999 to February 2009. The internal ring was closed with a 3-0 nonabsorbable suture. Both extracorporeal and intracorporeal methods of knotting were used. All patients were asked to return at 1 week and 6 weeks postoperatively for routine follow-up.
A contralateral patent processus vaginalis was present in 13% (45/352) of boys and 15% (12/83) of girls on the right side, and 7% (25/352) of boys and 6% (5/83) of girls on the left side. Follow-up range was from 1 week postoperatively to 108 months. There were 14 recurrences (2.4 % [14/576], 11 in boys and on the right side and 3 in girls) and 2 hydroceles 0.35% (2/576). Mean operating time was 23 minutes for unilateral and 29 minutes for bilateral inguinal hernia. There was neither metachronus hernia nor testicular atrophy observed during follow-up.
Laparoscopic inguinal hernia repair is technically easier, as there is no need to dissect the vas deferens and vessels. The risk of metachronous hernia is reduced, and we believe the cosmetic result is better. Although recurrences were more common early in the series, currently they are much less frequent. Laparoscopic inguinal hernia repair appears to have less morbidity than open herniotomy and can be used as routine procedure in the pediatric age group.
背景/目的：对接受腹腔镜腹股沟疝修补术的小儿患者前瞻性收集数据进行回顾性分析。
对 1999 年 6 月至 2009 年 2 月期间 437 例（年龄 30 天至 11 岁；中位数为 1.9 岁）576 例腹腔镜内环闭合术的前瞻性收集数据进行回顾性分析。内环用 3-0 非吸收缝线闭合。使用了体外和体内打结方法。所有患者均在术后 1 周和 6 周时返回进行常规随访。
右侧男孩中有 13%（45/352）和女孩中有 15%（12/83）存在对侧未闭的鞘状突，左侧男孩中有 7%（25/352）和女孩中有 6%（5/83）存在对侧未闭的鞘状突。随访范围从术后 1 周至 108 个月。有 14 例复发（2.4%[14/576]，11 例在男孩和右侧，3 例在女孩）和 2 例精索鞘膜积液（0.35%[2/576]）。单侧手术平均时间为 23 分钟，双侧手术平均时间为 29 分钟。随访期间未观察到同期疝或睾丸萎缩。
腹腔镜腹股沟疝修补术技术上更容易，因为不需要解剖输精管和血管。同期疝的风险降低，我们认为美容效果更好。尽管在系列早期复发更为常见，但目前复发频率较低。腹腔镜腹股沟疝修补术似乎比开放疝切开术发病率更低，可作为小儿患者的常规手术。
