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资源匮乏环境下的疝修补术：切口与技术的比较

Herniotomy in resource-scarce environment: Comparison of incisions and techniques.

作者信息

Ibrahim Musa, Getso Kabir Ibrahim, Mohammad Mohammad Aminu, Akhparov Nurlan Nurkenovich, Aipov Rassulbek Rakhmanberdievich

机构信息

Department of Surgery, Murtala Mohammad Specialist Hospital, Children Surgical Unit, Kano, Nigeria.

出版信息

Afr J Paediatr Surg. 2015 Jan-Mar;12(1):45-50. doi: 10.4103/0189-6725.150980.

DOI:10.4103/0189-6725.150980
PMID:25659550
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4955508/
Abstract

BACKGROUND

There are various methods for surgical treatment of hernia and hydrocele in children with variable cost-effectiveness, recovery and cosmetic outcomes. This study analyses our experience with mini-incision/invasive herniotomy in children in resource-limited centre.

MATERIALS AND METHODS

Seven hundred and eighty-four n = 784 patients underwent herniotomy via conventional and mini-invasive methods were assigned into Group A and Group B. Three hundred and seventy-six n = 376 (47.95%) in Group A while four hundred and eight n = 408 (52.04%) in Group B. Eight hundred and seventeen (817) herniotomy was performed. Demographic data, hernia/hydrocele sides, volume of surgical suture used, surgery duration, and complications analysed.

RESULTS

Right side hernia and/or hydrocele were 464 (59.18%). 287 (36.60%) had left sided while 33 (4.21%) had bilateral hernia and/or hydrocele. There were 14 bilateral hernia repair in Group A and 19 in Group B. The lengths of operation time for unilateral repair ranged from 14 to 54 min in Group A (median, 23 min) and 7-44 min in Group B (median, 15 min) with a mean surgical duration of 15.48 ± 4.16 min in Group B versus 23.41 ± 5.94 min in Group A (P < 0.001) while the range of the lengths of operation time for bilateral repair in Group A was 20-54 min (median, 36) and 12-30 min (median, 21) in Group B with a mean duration of 36.35 ± 9.89 min in Group A versus 20.42 ± 4.83 min in Group B P = 0.00563. 376 sachets of 45 cm suture material were used in Group A versus 137 in Group B. There were total of 87 (23.13%) complications in Group A versus 3 (1.47%) in Group B P = 0.000513. Superficial wound infection and abscess were 9 (2.36%) and 16 (4.25%) in Group A versus none (0) in Group B.

CONCLUSION

Mini-incision/invasive herniotomy in children and adolescents is fast, cost-effective with satisfactory cosmetic outcome and limited complications.

摘要

背景

儿童疝气和鞘膜积液的手术治疗方法多样，其成本效益、恢复情况及美容效果各不相同。本研究分析了我们在资源有限的中心对儿童进行小切口/微创疝修补术的经验。

材料与方法

784例患者接受了疝修补术，通过传统方法和微创方法分为A组和B组。A组376例（47.95%），B组408例（52.04%）。共进行了817例疝修补术。分析了人口统计学数据、疝气/鞘膜积液的部位、手术缝线用量、手术时间及并发症。

结果

右侧疝气和/或鞘膜积液464例（59.18%）。左侧287例（36.60%），双侧疝气和/或鞘膜积液33例（4.21%）。A组有14例双侧疝气修补，B组有19例。A组单侧修补手术时间为14至54分钟（中位数23分钟），B组为7至44分钟（中位数15分钟），B组平均手术时间为15.48±4.16分钟，A组为23.41±5.94分钟（P<0.001）；A组双侧修补手术时间为20至54分钟（中位数36），B组为12至30分钟（中位数21），A组平均手术时间为36.35±9.89分钟，B组为20.42±4.83分钟（P=0.00563）。A组使用了376包45厘米的缝线材料，B组为137包。A组共有87例（23.13%）并发症，B组为3例（1.47%）（P=0.000513）。A组浅表伤口感染和脓肿分别为9例（2.36%）和16例（4.25%），B组均无（0）。

结论

儿童和青少年小切口/微创疝修补术速度快、成本效益高，美容效果满意，并发症有限。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1c8/4955508/c76d5b1a0b8c/AJPS-12-45-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1c8/4955508/fcdb0af60bcb/AJPS-12-45-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1c8/4955508/e54ebd0fc3ad/AJPS-12-45-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1c8/4955508/c05d1ca70bda/AJPS-12-45-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1c8/4955508/2607f6b8cbf0/AJPS-12-45-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1c8/4955508/5296bea88be4/AJPS-12-45-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1c8/4955508/c76d5b1a0b8c/AJPS-12-45-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1c8/4955508/fcdb0af60bcb/AJPS-12-45-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1c8/4955508/e54ebd0fc3ad/AJPS-12-45-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1c8/4955508/c05d1ca70bda/AJPS-12-45-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1c8/4955508/2607f6b8cbf0/AJPS-12-45-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1c8/4955508/5296bea88be4/AJPS-12-45-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1c8/4955508/c76d5b1a0b8c/AJPS-12-45-g006.jpg

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