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一种用于小儿腹腔镜腹股沟疝修补术的更快、更简便的手术方法。

A Faster and Simpler Operation Method for Laparoscopic Inguinal Hernia Repair in Children.

作者信息

Wang Kun, Cai Jing, Lu Ying-Chou, Li Xiao-Wei, Zhai Guo-Min, He Wei-Bing, Guo Xiong-Sheng, Wu Gang-Quan

机构信息

Department of Pediatric Surgery and Dongguan Maternal and Child Health Hospital, Dongguan, Guangdong, China.

Reproductive Medicine Center, Dongguan Maternal and Child Health Hospital, Dongguan, Guangdong, China.

出版信息

J Laparoendosc Adv Surg Tech A. 2020 Jun;30(6):706-711. doi: 10.1089/lap.2019.0598. Epub 2020 Mar 27.

Abstract

Inguinal hernias (IHs) are common in infants and children. The key step in inguinal hernia repair is high ligation of the hernia sac. The current main treatment methods for IHs are open and laparoscopic surgery. Over the past two decades, laparoscopic herniorrhaphy has increased in popularity. Herein, we introduced a new method to laparoscopically treat IHs. The goal of this study was to investigate the clinical effects and advantages of this new operation technique for IHs, which is called the "hernia sac ligation by single-incision laparoscopic surgery with a double-line band method." We retrospectively reviewed the records of all children who underwent initial laparoscopic herniorrhaphy at our center over a 1-year period. A single surgeon performed all surgeries using the modified single-incision laparoscopic technique. Intraoperative findings and complications, operative times, and postoperative complications were reviewed for all children. All 119 surgeries were successfully completed (58 bilateral and 61 unilateral). In total, 54 out of 58 children had contralateral openings discovered at time of surgery and underwent unplanned bilateral laparoscopic hernia repair. This clinical study included 99 boys patients and 20 girls patients (boy-to-girl ratio was 4.95:1). The age range at the time of surgery was 0.5 to 10 years, and the average age was 2.63 years. No patient had any intraoperative complication. Postoperative complications occurred in 1 boy (0.56%) who had a hernia recurrence that required open repair. The addition of auxiliary operating forceps was required for 8 boys (6.72%). No child had scrotum edema, wound infection, stitch granuloma, or iatrogenic cryptorchidism. Overall, a 93.3% operative success rate was noted with the modified technique. The modified technique is a safe and effective operation method, which can significantly shorten the operation time, reduce recurrence rates, and result in minimal scarring. Additionally, the procedure is expected to be less expensive.

摘要

腹股沟疝(IHs)在婴幼儿和儿童中很常见。腹股沟疝修补的关键步骤是高位结扎疝囊。目前治疗IHs的主要方法是开放手术和腹腔镜手术。在过去二十年中,腹腔镜疝修补术越来越受欢迎。在此,我们介绍一种腹腔镜治疗IHs的新方法。本研究的目的是探讨这种名为“单切口腹腔镜双线带法疝囊结扎术”的IHs新手术技术的临床效果和优势。我们回顾性分析了本中心在1年期间接受初次腹腔镜疝修补术的所有儿童的记录。所有手术均由一名外科医生采用改良单切口腹腔镜技术完成。对所有儿童的术中发现和并发症、手术时间及术后并发症进行了评估。所有119例手术均成功完成(双侧58例,单侧61例)。58例儿童中有54例在手术时发现对侧开口,并接受了非计划性双侧腹腔镜疝修补术。本临床研究包括99例男性患者和20例女性患者(男女性别比为4.95:1)。手术时年龄范围为0.5至10岁,平均年龄为2.63岁。无患者发生术中并发症。1例男孩(0.56%)出现疝复发,需行开放修补术,发生了术后并发症。8例男孩(6.72%)需要增加辅助手术钳。无儿童发生阴囊水肿、伤口感染、缝线肉芽肿或医源性隐睾。总体而言,改良技术的手术成功率为93.3%。改良技术是一种安全有效的手术方法,可显著缩短手术时间,降低复发率,并使瘢痕最小化。此外,预计该手术费用更低。

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