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儿童腹腔镜腹股沟疝修补术结局的单中心回顾性研究

Single-center, retrospective study of the outcome of laparoscopic inguinal herniorrhaphy in children.

作者信息

Geiger Sucharitha, Bobylev Andrei, Schädelin Sabine, Mayr Johannes, Holland-Cunz Stefan, Zimmermann Peter

机构信息

Department of Pediatric Surgery, University Children's Hospital Basel Clinical Trial Unit, Department of Clinical Research, University Hospital Basel, Basel, Switzerland University Hospital for Pediatric Surgery Leipzig, Leipzig, Germany.

出版信息

Medicine (Baltimore). 2017 Dec;96(52):e9486. doi: 10.1097/MD.0000000000009486.

Abstract

Laparoscopic hernia repairs are used increasingly in children.The purpose of this single-center cohort observational research study was to analyze the outcome of children treated surgically for unilateral or bilateral inguinal hernia using laparoscopy.We did a STROBE-compliant retrospective outcome analysis of pediatric, laparoscopic hernia repair. Consecutive laparoscopic herniorrhaphies in 123 children done between March 2, 2010, and March 1, 2014, were included in this analysis. Data analysis was based on reviewing the hospital records and a prospective questionnaire. We evaluated postoperative hernia recurrence rate, occurrence of postoperative complications, duration of postoperative pain medication, and wound cosmesis.We first performed laparoscopic inguinal herniorrhaphy according to the techniques described by Schier et al and Becmeur et al in March 2010. We treated 46 girls and 77 boys with laparoscopically confirmed inguinal hernias, and their ages ranged from 0 to 16 years. Of these, 77 children suffered from unilateral hernias, 30 from unilateral hernias with contralateral patency of the vaginal process, and 16 from indirect bilateral hernias. The median follow-up interval was 38 months (range: 13-58 months). Overall, 8 (6.5%) of these 123 patients experienced a recurrence of the inguinal hernia. Two patients (1.6%) suffered a postoperative infection. Postoperative pain medication was administered by parents for 1 to 3 days in 67 (63.8%) of the 105 families who answered the question, and no pain medication was administered by 5 (4.0%) parents. Wound cosmesis was rated by the parents as invisible or barely visible in 106 (86.2%) of 123 patients and esthetically disturbing in 4 (3.2%) children.Laparoscopic inguinal hernia repair carries a learning curve and is safe and efficient in children thereafter. Further prospective studies are required to evaluate the long-term outcome of laparoscopic inguinal hernia repair in children.

摘要

腹腔镜疝修补术在儿童中的应用越来越广泛。这项单中心队列观察性研究的目的是分析采用腹腔镜手术治疗单侧或双侧腹股沟疝患儿的治疗结果。我们对小儿腹腔镜疝修补术进行了一项符合STROBE标准的回顾性结局分析。本分析纳入了2010年3月2日至2014年3月1日期间为123例患儿实施的连续腹腔镜疝修补术。数据分析基于查阅医院记录和一份前瞻性调查问卷。我们评估了术后疝复发率、术后并发症的发生情况、术后止痛药物使用时长以及伤口美观度。2010年3月,我们首先根据Schier等人和Becmeur等人描述的技术实施腹腔镜腹股沟疝修补术。我们治疗了46例女孩和77例男孩,他们经腹腔镜确诊患有腹股沟疝,年龄在0至16岁之间。其中,77例患儿患有单侧疝,30例患有单侧疝且对侧鞘突通畅,16例患有间接双侧疝。中位随访间隔为38个月(范围:13 - 58个月)。总体而言,这123例患者中有8例(6.5%)腹股沟疝复发。2例患者(1.6%)发生术后感染。在回答问题的105个家庭中,67个家庭(63.8%)的家长为患儿术后止痛用药1至3天,5个家庭(4.0%)的家长未给患儿使用止痛药物。123例患者中有106例(86.2%)家长对伤口美观度的评价为不可见或几乎不可见,4例患儿(3.2%)家长认为伤口美观度不佳。腹腔镜腹股沟疝修补术存在学习曲线,此后在儿童中是安全且有效的。需要进一步开展前瞻性研究以评估儿童腹腔镜腹股沟疝修补术的长期疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a45f/6393017/23db02389857/medi-96-e9486-g002.jpg

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