Pogorelić Zenon, Rikalo Marijana, Jukić Miro, Katić Josip, Jurić Ivo, Furlan Dubravko, Budimir Dražen, Biočić Mihovil
Department of Pediatric Surgery, Split University Hospital Center and Split University School of Medicine, Spinčićeva 1, 21 000, Split, Croatia.
School of Medicine, University of Split, Šoltanska 2, 21 000, Split, Croatia.
Surg Today. 2017 Jan;47(1):108-113. doi: 10.1007/s00595-016-1352-2. Epub 2016 May 11.
To evaluate the management and outcomes of modified Marcy repair for inguinal hernia in a large series of children.
We analyzed the case records of 6826 pediatric patients who underwent surgery for inguinal hernia between January, 1991 and January, 2015 at Split University Hospital in Croatia. The following parameters were examined: sex, age, location of the hernia, intraoperative or postoperative complications, recurrence, and surgical method.
The 6826 patients included 4751 boys and 2075 girls operated on for inguinal hernia. The mean age was 3.5 years, and mean followup was 14 years. Right-side predominance was noted with 59.50 % right hernia repairs, 33.72 % left hernia repairs, and 6.78 % bilateral hernia repairs. There were 6410 (93.90 %) elective procedures and 416 (6.10 %) emergency procedures for incarceration. The mean duration of surgery was 26 min (14-90 min), and the mean hospital stay was 1 day. Marcy repair was the most commonly performed operation (95.76 %), whereas Ferguson's technique was performed in only 3.98 % of the children. The overall recurrence rate was 0.43 %, with a recurrence rate of 0.36 % for Marcy repair and 1.83 % for Ferguson repair (p = 0.0003).
Modified Marcy hernia repair is a safe and effective procedure for inguinal hernia in children with excellent outcomes and a low incidence of recurrence.
评估改良马尔西修补术治疗大量儿童腹股沟疝的管理方法及治疗效果。
我们分析了1991年1月至2015年1月在克罗地亚斯普利特大学医院接受腹股沟疝手术的6826例儿科患者的病历。检查了以下参数：性别、年龄、疝的位置、术中或术后并发症、复发情况及手术方法。
6826例患者中，4751例为男孩，2075例为女孩接受腹股沟疝手术。平均年龄为3.5岁，平均随访时间为14年。右侧疝占优势，右侧疝修补术占59.50%，左侧疝修补术占33.72%，双侧疝修补术占6.78%。有6410例（93.90%）为择期手术，416例（6.10%）为嵌顿急诊手术。平均手术时间为26分钟（14 - 90分钟），平均住院时间为1天。马尔西修补术是最常用的手术方式（95.76%），而仅3.98%的儿童采用弗格森技术。总体复发率为0.43%，马尔西修补术的复发率为0.36%，弗格森修补术的复发率为1.83%（p = 0.0003）。
改良马尔西疝修补术是治疗儿童腹股沟疝的一种安全有效的方法，治疗效果良好，复发率低。
