Esposito C, Turial S, Escolino M, Giurin I, Alicchio F, Enders J, Krause K, Settimi A, Schier F
Department of Pediatrics, Pediatric Surgery, Federico II University of Naples, Via Pansini 5, Naples, 80131, Italy.
Pediatr Surg Int. 2012 Oct;28(10):989-92. doi: 10.1007/s00383-012-3156-9. Epub 2012 Aug 9.
This retrospective study aims to evaluate the feasibility, safety and complication rate of laparoscopic inguinal hernia repair for small babies weighing 3 kg or less.
A retrospective analysis was performed on the surgical charts of 67 infants (47 boys and 20 girls) weighing 3 kg or less who underwent laparoscopic hernia repair in a 3-year period. A regular 5-mm scope was used for visualization, and 2 or 3-mm instruments were used for the closure of the inner inguinal ring using 3/0 non-absorbable suture. The median weight at surgery was 2,600 g (range 1,450-3,000 g). All except three were premature.
Of the 67 infants, 15 (22.3 %) presented with an irreducible hernia. In three cases of irreducible hernias, we also performed a transumbilical appendectomy at the end of the hernia repair. Minor problems related with anesthesia were noted in four cases. Hernia recurrence was observed in three patients (4.4 %). No cases of testicular atrophy occurred. In 10 boys, we observed 12 cases of high testes, only 4 testes requiring subsequent orchiopexy.
Laparoscopic inguinal hernia repair for babies weighing 3 kg or less is feasible, safe and perhaps even less technically demanding than open inguinal herniotomy.
本回顾性研究旨在评估腹腔镜腹股沟疝修补术对体重3千克及以下小婴儿的可行性、安全性及并发症发生率。
对67例体重3千克及以下的婴儿（47例男孩和20例女孩）的手术记录进行回顾性分析，这些婴儿在3年期间接受了腹腔镜疝修补术。使用常规5毫米的腹腔镜进行可视化操作，使用2或3毫米的器械，用3/0不可吸收缝线闭合腹股沟内环。手术时的中位体重为2600克（范围1450 - 3000克）。除3例以外，所有婴儿均为早产儿。
67例婴儿中，15例（22.3%）出现难复性疝。在3例难复性疝病例中，我们在疝修补术结束时还进行了经脐阑尾切除术。4例出现与麻醉相关的小问题。3例患者（4.4%）观察到疝复发。未发生睾丸萎缩病例。在10例男孩中，我们观察到12例高位睾丸，只有4个睾丸需要后续进行睾丸固定术。
对于体重3千克及以下的婴儿，腹腔镜腹股沟疝修补术是可行、安全的，甚至在技术上可能比开放性腹股沟疝修补术要求更低。
