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经单一传统端口腹腔内常规器械-内镜手术行间接腹股沟疝修补术。

Indirect inguinal hernia repair conducted with single conventional port intracorporeal conventional equipment-endoscopic surgery.

机构信息

Department of Pediatric Surgery, Medical School, Dokuz Eylül University, Balçova, 35340, Izmir, Turkey.

出版信息

Hernia. 2020 Oct;24(5):1063-1068. doi: 10.1007/s10029-020-02165-y. Epub 2020 Mar 9.

Abstract

PURPOSE

Laparoscopic or laparoscopy-assisted inguinal hernia repair (IHR) can be performed using one port plus two stab wounds. We herein present our experience with laparoscopic IHR conducted using a single conventional port and a single working instrument.

METHODS

The records patients who underwent single conventional port intracorporeal IHR during November 2013-December 2018 were evaluated. The main outcome measurements were patient's demographic characteristics, hernia side, presence of incarceration, operative time, and complications.

RESULTS

A total of 132 inguinal hernias (52 right, 40 left, and 20 bilateral) were repaired in 112 patients (76 boys, 36 girls). The mean ages of the patients were 69.8 ± 53.4 months (3 months to 17 years). In six patients, contralateral processus vaginalis was found to be patent during operation. Incarcerated inguinal hernia was present in two patients. Mean operative time was 17.9 ± 3.8 min (9-30 min) in unilateral hernias and 28.9 ± 6.5 min (24-45 min) in bilateral hernias. No intraoperative and postoperative complications were encountered. The mean hospital stay of the patients was 8.8 ± 5.0 h (4-36 h). Postoperative follow-up was 16.5 ± 5.1 months (6-24 months). No recurrent inguinal hernias were detected during follow-up.

CONCLUSION

Single conventional port intracorporeal IHR obviates additional stab wounds. Additionally, present technique eliminates the risk of skin puckering, subcutaneous granuloma, infection, nerve, and muscle damage development induced by the subcutaneously placed knot in laparoscopy-assisted IHR. Single conventional port intracorporeal IHR in children is a feasible and safe operative technique with low complication rates.

摘要

目的

腹腔镜或腹腔镜辅助腹股沟疝修补术(IHR)可通过一个端口加两个戳口完成。本文介绍了我们使用单个常规端口和单个手术器械进行腹腔镜 IHR 的经验。

方法

评估了 2013 年 11 月至 2018 年 12 月期间接受单常规端口经腔 IHR 的患者记录。主要的测量结果是患者的人口统计学特征、疝侧、嵌顿的存在、手术时间和并发症。

结果

共有 112 名患者(76 名男孩,36 名女孩)进行了 132 例腹股沟疝(52 例右侧,40 例左侧,20 例双侧)修复。患者的平均年龄为 69.8±53.4 个月(3 个月至 17 岁)。在 6 例患者中,手术中发现对侧鞘突未闭。有 2 例嵌顿性腹股沟疝。单侧疝的平均手术时间为 17.9±3.8 分钟(9-30 分钟),双侧疝为 28.9±6.5 分钟(24-45 分钟)。术中及术后均无并发症。患者的平均住院时间为 8.8±5.0 小时(4-36 小时)。术后随访 16.5±5.1 个月(6-24 个月)。随访期间未发现复发性腹股沟疝。

结论

单常规端口经腔 IHR 避免了额外的戳口。此外,本技术消除了腹腔镜辅助 IHR 中皮下放置结引起的皮肤皱缩、皮下肉芽肿、感染、神经和肌肉损伤的风险。儿童单常规端口经腔 IHR 是一种具有低并发症发生率的可行且安全的手术技术。

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