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体重3公斤及以下早产儿的腹腔镜腹股沟疝修补术。

Laparoscopic inguinal hernia repair in premature babies weighing 3 kg or less.

作者信息

Esposito C, Turial S, Escolino M, Giurin I, Alicchio F, Enders J, Krause K, Settimi A, Schier F

机构信息

Department of Pediatrics, Pediatric Surgery, Federico II University of Naples, Via Pansini 5, Naples, 80131, Italy.

出版信息

Pediatr Surg Int. 2012 Oct;28(10):989-92. doi: 10.1007/s00383-012-3156-9. Epub 2012 Aug 9.

Abstract

PURPOSE

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

Laparoscopic inguinal hernia repair for babies weighing 3 kg or less is feasible, safe and perhaps even less technically demanding than open inguinal herniotomy.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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