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婴儿腹股沟疝的腹腔镜修补术:与开放疝修补术的比较。

Laparoscopic repair of inguinal hernia in infants: Comparison with open hernia repair.

作者信息

Ho In Geol, Ihn Kyong, Koo Eun-Jung, Chang Eun Young, Oh Jung-Tak

机构信息

Department of Pediatric Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

Department of Pediatric Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

出版信息

J Pediatr Surg. 2018 Oct;53(10):2008-2012. doi: 10.1016/j.jpedsurg.2018.01.022. Epub 2018 Feb 7.

DOI:10.1016/j.jpedsurg.2018.01.022
PMID:29477445
Abstract

PURPOSE

This study aimed to evaluate the usefulness of laparoscopic repair of inguinal hernia (LR) in infants in comparison with open hernia repair (OR).

METHODS

We retrospectively analyzed the clinical data of 465 infants treated for inguinal hernia from January 2006 to December 2015. Among them, 124 underwent LR and 341 underwent OR.

RESULTS

In the OR group, 16.1% (55/341) primarily underwent bilateral inguinal hernia repair and 13.6% (42/308) subsequently developed metachronous contralateral inguinal hernia during follow-up. In the LR group, 75.8% (94/124) underwent primary bilateral inguinal hernia repair and only 1.6% (2/123) developed metachronous contralateral inguinal hernia. The mean operation times of unilateral inguinal hernia repair showed no statistical differences between LR and OR. However, the mean operation times of bilateral inguinal hernia repair were shorter in LR (39.8±10.4 vs. 51.1±14.4min, p<0.001). Postoperative recurrence and wound infection showed no statistical differences between the groups, but postoperative scrotal swelling was more common in OR (0.0% vs. 4.0%, p=0.006).

CONCLUSION

LR in infants showed a lower incidence of metachronous hernia, shorter operation times, and better postoperative course than OR. LR could be considered the primary operation method in infants with inguinal hernia.

LEVELS OF EVIDENCE

Prognosis Study, Retrospective Study, Level III.

摘要

目的

本研究旨在比较腹腔镜腹股沟疝修补术(LR)与开放疝修补术(OR)在婴儿腹股沟疝治疗中的有效性。

方法

我们回顾性分析了2006年1月至2015年12月期间465例接受腹股沟疝治疗的婴儿的临床资料。其中,124例行LR,341例行OR。

结果

在OR组中,16.1%(55/341)最初接受双侧腹股沟疝修补术,13.6%(42/308)在随访期间随后发生异时性对侧腹股沟疝。在LR组中,75.8%(94/124)接受了原发性双侧腹股沟疝修补术,只有1.6%(2/123)发生异时性对侧腹股沟疝。单侧腹股沟疝修补术的平均手术时间在LR和OR之间无统计学差异。然而,LR组双侧腹股沟疝修补术的平均手术时间较短(39.8±10.4对51.1±14.4分钟,p<0.001)。术后复发和伤口感染在两组之间无统计学差异,但OR组术后阴囊肿胀更常见(0.0%对4.0%,p=0.006)。

结论

与OR相比,婴儿LR的异时性疝发生率更低,手术时间更短,术后病程更好。LR可被视为婴儿腹股沟疝的主要手术方法。

证据水平

预后研究,回顾性研究,III级。

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