Yoshimaru Koichiro, Kinoshita Yoshiaki, Shono Takeshi
1 Department of Pediatric Surgery, Saga-Ken Medical Center Koseikan , Saga, Japan .
2 Department of Pediatric Surgery, Kyushu University , Fukuoka, Japan .
J Laparoendosc Adv Surg Tech A. 2017 Jan;27(1):91-96. doi: 10.1089/lap.2015.0364. Epub 2015 Nov 18.
Laparoscopic percutaneous extraperitoneal closure (LPEC) has been performed in Japan for the repair of the pediatric inguinal hernias for over a decade. However, the safety and efficacy of LPEC in neonates and infants under 1 year of age remain unknown. The aim of the present study is to elucidate the safety and efficacy of LPEC in the treatment of inguinal hernia in patients who are younger than 1 year of age.
The medical records of the patients who underwent LPEC at Saga-Ken Medical Center Koseikan (Saga, Japan) between August 2007 and November 2012 were collected. The intraoperative findings and postoperative outcomes were retrospectively investigated. The data of the patients who were younger than 1 year of age (Group A) were compared with the data of patients who were older than 1 year of age (Group B).
During the study period, 150 LPEC procedures were performed in 112 Group A patients, whereas 607 LPEC procedures were performed in 456 Group B patients. There were no serious complications in either group. After a mean follow-up period of 50.4 ± 15.6 months (range, 28-91 months), there were no significant differences between the two groups in the operating time or the incidence of intraoperative or postoperative complications. Postoperative testicular ascent and recurrence were observed in some cases of each group.
LPEC is a safe and effective procedure for the repair of an inguinal hernia, even in neonatal and infant patients who are younger than 1 year of age.
在日本,腹腔镜经皮腹膜外闭合术(LPEC)已用于小儿腹股沟疝修补术十余年。然而,LPEC在1岁以下新生儿和婴儿中的安全性和有效性仍不清楚。本研究的目的是阐明LPEC治疗1岁以下腹股沟疝患者的安全性和有效性。
收集2007年8月至2012年11月在日本佐贺县立医疗中心兴善馆接受LPEC治疗的患者的病历。回顾性研究术中发现及术后结果。将1岁以下患者(A组)的数据与1岁以上患者(B组)的数据进行比较。
研究期间,112例A组患者进行了150例LPEC手术,而456例B组患者进行了607例LPEC手术。两组均无严重并发症。平均随访50.4±15.6个月(范围28 - 91个月)后,两组在手术时间、术中或术后并发症发生率方面无显著差异。每组部分病例观察到术后睾丸上升和复发情况。
LPEC是一种安全有效的腹股沟疝修补手术,即使对于1岁以下的新生儿和婴儿患者也是如此。