Department of Pediatrics, Pediatric Surgery, Federico II University of Naples, Via Pansini 5, 80131, Naples, Italy.
Hernia. 2013 Apr;17(2):235-9. doi: 10.1007/s10029-012-0948-8. Epub 2012 Jul 8.
The purpose of our retrospective study was to describe the efficacy and the advantages of laparoscopic approach to treat incarcerated inguinal hernia (IIH) in pediatric patients.
In a 2-year period, 601 children underwent a laparoscopic inguinal hernia repair, 46 (7.6 %) of them presented an IIH. Our study will be focused on these 46 patients: 30 boys and 16 girls (age range 1 month-8 years).
Twenty-one/46 hernias (45.6 %) were reduced preoperatively and then operated laparoscopically (RH), 25/46 (54.4 %) were irreducible and they were operated directly in laparoscopy (IRH). We have no conversions in our series. The length of surgery in RH group was in median 23 min and in IRH group was in median 30 min. Hospital stay was variable between 6 h and 3 days (median 36 h).With a minimum follow-up of 14 months, we had 2/46 recurrences (4.3 %).
The laparoscopic approach to IIH appears easy to perform from the technical point of view. The 3 main advantages of laparoscopic approach are that all edematous tissue are surgically bypassed and the cord structures are not touched; the reduction is performed under direct visual control, and above all, an inspection of the incarcerated organ is performed at the end of procedure.
本回顾性研究的目的是描述腹腔镜治疗小儿嵌顿性腹股沟疝（IIH）的疗效和优势。
在 2 年期间，601 例儿童接受了腹腔镜腹股沟疝修补术，其中 46 例（7.6%）为 IIH。我们的研究将集中在这 46 例患者：30 例男孩和 16 例女孩（年龄 1 个月至 8 岁）。
21/46 例（45.6%）疝在术前可复位，然后行腹腔镜手术（RH），25/46 例（54.4%）疝不可复位，直接行腹腔镜手术（IRH）。我们的系列手术中没有中转开腹。RH 组手术时间中位数为 23 分钟，IRH 组手术时间中位数为 30 分钟。住院时间在 6 小时至 3 天之间不等（中位数 36 小时）。随访时间最短为 14 个月，我们有 2/46 例（4.3%）复发。
从技术角度来看，腹腔镜治疗 IIH 似乎很容易实施。腹腔镜治疗的 3 个主要优势是所有水肿组织均被手术绕过，且不触及精索结构；复位在直视下进行，最重要的是，在手术结束时对嵌顿器官进行检查。
