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改良单孔腹腔镜小儿腹股沟疝疝修补术:中国 1107 例报告。

Modified single-port laparoscopic herniorrhaphy for pediatric inguinal hernias: based on 1,107 cases in China.

机构信息

Department of Pediatrics Surgery, The Affiliated Hexian Memorial Hospital of Southern Medical University, No. 2, QingHe Road (East), PanYu District, Guangzhou, 511400, China.

出版信息

Surg Endosc. 2012 Dec;26(12):3663-8. doi: 10.1007/s00464-012-2396-z. Epub 2012 Jul 7.

Abstract

BACKGROUND

Laparoscopic surgery is an alternative procedure for pediatric inguinal hernia (PIH), with a major trend toward increasing use of extracorporeal knotting and decreasing use of working ports. We report our experience with the modified single-port laparoscopic herniorrhaphy for repair of PIH and retrospectively evaluate a consecutive series of 1,107 cases in our institution.

METHODS

Between February 2006 and July 2011, 1,107 children with indirect inguinal hernia were treated by laparoscopic surgery. All patients underwent high ligation surgery with a modified single-port laparoscopic technique, mainly performed by extracorporeal suturing with an ordinary taper needle (1/2 Arc 11 × 34). The clinical data were retrospectively analyzed.

RESULTS

All surgery was successful without any serious complications. During the operations, contralateral patent processus vaginalis was found and subsequently repaired in 221 cases (20.0%). The mean operative time was 11 (range 5-14) min in 815 cases of unilateral repair and 20 (range 14-27) min in 292 cases of bilateral repair. The mean of postoperative hospital stay was 48 (range 26-52) h. Complications occurred in seven cases (0.63%) and were properly managed, with no major impact on outcome of the operations. There were six recurrent cases (0.54%) in the patients who had been followed-up for 9-74 months. There was no obvious scaring visible in any patients after treatment.

CONCLUSIONS

The modified single-port laparoscopic technique for the repair of PIH is a safe and reliable procedure with minimal invasion and satisfactory outcome. It is easy to perfect and to perform and therefore is a worthy choice for PIH.

摘要

背景

腹腔镜手术是小儿腹股沟疝(PIH)的一种替代手术方法,其主要趋势是越来越多地使用体外打结和减少使用工作端口。我们报告了我们使用改良的单孔腹腔镜疝修补术治疗 PIH 的经验,并回顾性评估了我们机构连续的 1107 例病例。

方法

在 2006 年 2 月至 2011 年 7 月期间,1107 例儿童腹股沟斜疝患者接受了腹腔镜手术治疗。所有患者均采用改良的单孔腹腔镜技术行高位结扎术,主要采用普通锥形针(1/2 Arc 11×34)进行体外缝合。回顾性分析临床资料。

结果

所有手术均成功,无严重并发症。在手术过程中,发现对侧未闭的鞘状突并随后修复了 221 例(20.0%)。单侧修补术的平均手术时间为 11 分钟(范围 5-14 分钟),双侧修补术的平均手术时间为 20 分钟(范围 14-27 分钟)。术后平均住院时间为 48 小时(范围 26-52 小时)。7 例(0.63%)发生并发症,经妥善处理,对手术结果无重大影响。随访 9-74 个月,有 6 例(0.54%)复发。治疗后,所有患者均无明显疤痕。

结论

改良的单孔腹腔镜技术治疗 PIH 是一种安全可靠的方法,具有微创性和良好的效果。操作简单,易于完善,是治疗 PIH 的一种值得选择的方法。

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