Department of Paediatric Surgery, Şişli Etfal Training and Research Hospital, 34381 Istanbul, Turkey.
J Pediatr Surg. 2012 Sep;47(9):1706-10. doi: 10.1016/j.jpedsurg.2012.03.044.
The aim of this study was to evaluate, using Doppler ultrasonography, the effects of different hernia repair techniques on testicular perfusion in the pediatric age group.
This study was based on a prospective clinical trial of 72 pediatric patients over 2 years of age with unilateral inguinal hernia. They were operated on using 1 of 3 different techniques. Group 1 included 26 patients who were treated with a conventional open hernia repair technique. Group 2 included 22 patients who underwent Schier intracorporeal laparoscopic suture technique. Group 3 included 24 patients who underwent the laparoscopic partial excision and purse-string technique described by Montupet. In all cases, blood flow index of the centripetal and capsular arteries of the testes, including peak systolic velocity (PSV) and resistivity index (RI), were examined by using Doppler ultrasound preoperatively and early and late postoperatively.
The conventional open technique group (group 1) had transient temporary changes in PSV and RI values compared with preoperative findings; however, these changes were not statistically significant. No such changes were observed in the 2 laparoscopic groups.
Neither conventional open nor laparoscopic hernia repair techniques impaired testes vascularization. Surgical manipulations performed using the conventional open repair technique caused transient, but not significant, changes in PSV and RI values.
本研究旨在使用多普勒超声评估不同疝修补技术对小儿年龄组睾丸灌注的影响。
这是一项为期 2 年的前瞻性临床试验，纳入了 72 名年龄大于 2 岁的单侧腹股沟疝患儿。他们接受了 3 种不同技术中的 1 种手术。第 1 组 26 例患者接受传统开放疝修补术。第 2 组 22 例患者接受 Schier 经腹腔内腹腔镜缝合技术。第 3 组 24 例患者接受 Montupet 描述的腹腔镜部分切除和荷包缝合技术。在所有情况下，均使用多普勒超声在术前、术后早期和晚期检查睾丸的向心和囊状动脉的血流指数，包括收缩期峰值速度（PSV）和阻力指数（RI）。
与术前发现相比，传统开放技术组（第 1 组）的 PSV 和 RI 值出现短暂的暂时变化，但这些变化无统计学意义。在 2 个腹腔镜组中未观察到这种变化。
无论是传统的开放还是腹腔镜疝修补技术都不会损害睾丸的血管化。使用传统开放修复技术进行的手术操作会导致 PSV 和 RI 值短暂但无显著变化。
