Steven Mairi, Greene Owen, Nelson Adam, Brindley Nicola
Department of Surgical Pediatrics, Royal Hospital for Sick Children, Dalnair Street, Glasgow, G3 8SJ, UK.
Pediatr Surg Int. 2010 Jul;26(7):703-6. doi: 10.1007/s00383-010-2614-5. Epub 2010 May 8.
The purpose of this study was to review our management of neonatal inguinal hernias in premature infants over a 5-year period to ascertain any change in practice.
Premature infants who underwent inguinal herniotomy between 2002 and 2006 were identified. Case notes were analyzed recording patient demographics, primary side, complications, recurrence and how many re-presented with a metachronous hernia.
172 preterm infants were identified: 162 males (94.2%) and 10 females (5.8%). Median gestation was 31 weeks (25-36.7). Eighteen (10.4%) were incarcerated. Median age at surgery was 66.5 days (0-284). Thirty-two (18.6%) had bilateral hernias. Of the 63 who underwent unilateral herniotomy, 9 (14.3%) re-presented with a metachronous hernia. Median time to returning was 24 days. The number of contralateral explorations decreased over the study period. The complication rate was 6.4%. Median follow-up was 2.83 years (0.33-5.4).
This is one of the largest series showing the current practice in managing preterm infants with inguinal hernia. There are limitations to this study and the follow-up period is short. The value of contralateral groin exploration in premature neonates remains doubtful and we have shown that the overall practice has changed.
本研究旨在回顾我们在5年期间对早产儿腹股沟疝的管理情况，以确定实践中的任何变化。
确定2002年至2006年间接受腹股沟疝修补术的早产儿。分析病例记录，记录患者人口统计学资料、主要患侧、并发症、复发情况以及有多少患者再次出现异时性疝。
共确定172例早产儿：162例男性（94.2%），10例女性（5.8%）。中位孕周为31周（25 - 36.7周）。18例（10.4%）发生嵌顿。手术时的中位年龄为66.5天（0 - 284天）。32例（18.6%）为双侧疝。在接受单侧疝修补术的63例患者中，9例（14.3%）再次出现异时性疝。再次出现的中位时间为24天。在研究期间，对侧探查的次数有所减少。并发症发生率为6.4%。中位随访时间为2.83年（0.33 - 5.4年）。
这是展示当前管理早产儿腹股沟疝实践的最大系列研究之一。本研究存在局限性，且随访期较短。早产儿对侧腹股沟探查的价值仍存疑问，并且我们已表明总体实践情况有所变化。
