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小儿嵌顿性腹股沟疝经脐单孔腹腔镜手术与传统修补术的对比研究

A comparative study on trans-umbilical single-port laparoscopic approach versus conventional repair for incarcerated inguinal hernia in children.

作者信息

Jun Zhang, Juntao Ge, Shuli Liu, Li Long

机构信息

Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, People's Republic of China.

Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, People's Republic of China; Department of Pediatric Surgery, Qianfo Hill Hospital, Shandong Province, People's Republic of China.

出版信息

J Minim Access Surg. 2016 Apr-Jun;12(2):139-42. doi: 10.4103/0972-9941.169953.

Abstract

PURPOSE

The purpose of this study is to determine whether singleport laparoscopic repair (SLR) for incarcerated inguinal hernia in children is superior toconventional repair (CR) approaches.

METHOD

Between March 2013 and September 2013, 126 infants and children treatedwere retrospectively reviewed. All the patients were divided into three groups. Group A (48 patients) underwent trans-umbilical SLR, group B (36 patients) was subjected to trans-umbilical conventional two-port laparoscopic repair (TLR) while the conventional open surgery repair (COR) was performed in group C (42 patients). Data regarding the operating time, bleeding volume, post-operative hydrocele formation, testicular atrophy, cosmetic results, recurrence rate, and duration of hospital stay of the patients were collected.

RESULT

All the cases were completed successfully without conversion. The mean operative time for group A was 15 ± 3.9 min and 24 ± 7.2 min for unilateral hernia and bilateral hernia respectively, whereas for group B, it was 13 ± 6.7 min and 23 ± 9.2 min. The mean duration of surgery in group C was 35 ± 5.2 min for unilateral hernia. The recurrence rate was 0% in all the three groups. There were statistically significant differences in theoperating time, bleeding volume, post-operative hydrocele formation, cosmetic results and duration hospital stay between the three groups (P < 0.001). No statistically significant differences between SLR and TLR were observed except the more cosmetic result in SLR.

CONCLUSION

SLR is safe and effective, minimally invasive, and is a new technology worth promoting.

摘要

目的

本研究旨在确定儿童嵌顿性腹股沟疝的单孔腹腔镜修补术(SLR)是否优于传统修补术(CR)。

方法

回顾性分析2013年3月至2013年9月期间接受治疗的126例婴幼儿及儿童。所有患者分为三组。A组(48例)接受经脐单孔腹腔镜修补术,B组(36例)接受经脐传统两孔腹腔镜修补术(TLR),而C组(42例)进行传统开放手术修补术(COR)。收集患者的手术时间、出血量、术后鞘膜积液形成、睾丸萎缩、美容效果、复发率及住院时间等数据。

结果

所有病例均成功完成,无中转情况。A组单侧疝平均手术时间为15±3.9分钟,双侧疝为24±7.2分钟;B组单侧疝平均手术时间为13±6.7分钟,双侧疝为23±9.2分钟。C组单侧疝平均手术时间为35±5.2分钟。三组复发率均为0%。三组在手术时间、出血量、术后鞘膜积液形成、美容效果及住院时间方面存在统计学显著差异(P<0.001)。除SLR美容效果更佳外,SLR与TLR之间未观察到统计学显著差异。

结论

单孔腹腔镜修补术安全有效、微创,是一项值得推广的新技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9573/4810947/545041a26274/JMAS-12-139-g001.jpg

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