Shalaby Rafik, Ibrahem Refaat, Shahin Mohamed, Yehya Abdelaziz, Abdalrazek Mohamed, Alsayaad Ibrahim, Shouker Maged Ali
Pediatric Surgery Unit, Al-Azhar University Hospitals, Cairo, Egypt.
Minim Invasive Surg. 2012;2012:484135. doi: 10.1155/2012/484135. Epub 2012 Dec 27.
Background. Laparoscopic hernia repair in infancy and childhood is still debatable. The objective of this study is to compare laparoscopic assisted hernia repair versus open herniotomy as regards operative time, hospital stay, postoperative hydrocele formation, recurrence rate, iatrogenic ascent of the testis, testicular atrophy, and cosmetic results. Patients and Methods. Two hundred and fifty patients with inguinal hernia were randomized into two equal groups. Group A was subjected to laparoscopic inguinal hernia repair. Group B was subjected to open herniotomy. The demographic data were matched between both groups. Assessment of the testicular volume and duplex assessment in preoperative, early, and late postoperative periods were done. Results. All cases were completed successfully without conversion. The mean operative time for group A was 7.6 ± 3.5 minutes, 9.2 ± 4.6 minutes and 11.4 ± 2.7 minutes, for unilateral hernia, unilateral hernia in obese child, and bilateral hernia, respectively. The recurrence rate was 0.8% in group A, whereas in group B the recurrence rate was 2.4%. Conclusion. Laparoscopic hernia repair by RN is an effective line of hernia repair. It resulted in marked reduction of operative time, low rate of recurrence, no testicular atrophy, no iatrogenic ascent of the testis, and excellent cosmetic results.
背景。婴儿期和儿童期的腹腔镜疝修补术仍存在争议。本研究的目的是比较腹腔镜辅助疝修补术与开放性疝囊高位结扎术在手术时间、住院时间、术后鞘膜积液形成、复发率、睾丸医源性上升、睾丸萎缩和美容效果方面的差异。
患者与方法。250例腹股沟疝患者被随机分为两组，每组125例。A组接受腹腔镜腹股沟疝修补术，B组接受开放性疝囊高位结扎术。两组患者的人口统计学数据相匹配。在术前、术后早期和晚期对睾丸体积进行评估并进行双功超声检查。
结果。所有病例均成功完成，无一例中转。A组单侧疝、肥胖儿童单侧疝和双侧疝的平均手术时间分别为7.6±3.5分钟、9.2±4.6分钟和11.4±2.7分钟。A组的复发率为0.8%，而B组的复发率为2.4%。
结论。由注册护士进行的腹腔镜疝修补术是一种有效的疝修补方法。它显著缩短了手术时间，降低了复发率，无睾丸萎缩，无睾丸医源性上升，美容效果良好。
