Zhu Haitao, Li Jun, Peng Xueni, Alganabi Mashriq, Zheng Shan, Shen Chun, Dong Kuiran
Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai, China.
Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
J Laparoendosc Adv Surg Tech A. 2019 Oct;29(10):1297-1301. doi: 10.1089/lap.2019.0119. Epub 2019 Aug 8.
Laparoscopic repair has become the preferred option for the treatment of pediatric hernias. Recently, laparoscopic operations have also been conducted in pediatric recurrent hernia cases. Laparoscopic percutaneous extraperitoneal closure (LPEC) is a simple and reliable minimally invasive procedure for pediatric inguinal hernia repair. However, it is still unclear whether LPEC is an ideal procedure for recurrent inguinal hernias in children. The aim of this study is to evaluate the efficacy of LPEC in the treatment of pediatric recurrent inguinal hernias. We retrospectively reviewed all children with primary inguinal hernia repairs in our hospital from 2016 to 2017 and analyzed the outcomes of recurrent inguinal hernia repairs with LPEC. There were 1703 children with 1985 indirect inguinal hernias: 1549 were laparoscopic (91.0%) and 154 open (9.0%). Thirty-five (2.1%) of these children had recurrent inguinal hernia with no difference in prevalence between laparoscopic and open ( = .24). One case was bilateral. LPEC was performed successfully in all children with recurrent inguinal hernias. There were no severe intra- or postoperative complications in any of the recurrent cases. No children had inguinal hernia recurrence at follow-up (8 months-2 years). LPEC of the internal ring is a reliable and effective minimally invasive technique for the treatment of recurrent inguinal hernia in children.
腹腔镜修补术已成为治疗小儿疝气的首选方法。最近,腹腔镜手术也已应用于小儿复发性疝气病例。腹腔镜经皮腹膜外闭合术(LPEC)是一种用于小儿腹股沟疝修补的简单可靠的微创手术。然而,LPEC是否是治疗小儿复发性腹股沟疝的理想手术仍不清楚。本研究的目的是评估LPEC治疗小儿复发性腹股沟疝的疗效。我们回顾性分析了2016年至2017年在我院接受原发性腹股沟疝修补术的所有患儿,并分析了采用LPEC进行复发性腹股沟疝修补术的结果。共有1703名患儿,1985例间接腹股沟疝:1549例为腹腔镜手术(91.0%),154例为开放手术(9.0%)。其中35例(2.1%)患儿出现复发性腹股沟疝,腹腔镜手术和开放手术的患病率无差异(P = 0.24)。1例为双侧。所有复发性腹股沟疝患儿均成功进行了LPEC手术。所有复发病例均未出现严重的术中或术后并发症。随访(8个月至2年)期间无患儿腹股沟疝复发。内环LPEC是治疗小儿复发性腹股沟疝的一种可靠且有效的微创手术技术。