婴儿腹股沟疝的延迟修补术评估。

Division of General Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.

Panaroma, Private Practice, South Africa.

S Afr J Surg. 2020 Mar;58(1):18-21.

BACKGROUND

Potential strangulation of infant inguinal hernias is the main indication for their urgent repair. Lack of theatre time delays repair and prolongs hospitalisation. We report a series of patients with uncomplicated hernias who were discharged home to have their elective surgery at a later stage and assessed the outcomes of this approach.

METHODS

A retrospective audit was performed of all infants with an inguinal hernia from January 2010 to June 2015. Incomplete records and infants operated after their first birthday were excluded. Two groups were identified; immediate surgery for infants with uncomplicated hernias, and delayed surgery for infants with uncomplicated hernias. Incarceration/strangulation rates in the interim period were documented for the delayed group, and comparison made between the groups regarding perioperative and anaesthetic complications and length of postoperative hospital stay.

RESULTS

The mean time delay between diagnosis and repair was 8.78 weeks. None of the hernias in the delay group strangulated while awaiting repair. There was no significant difference in the perioperative complications between the two groups. Out of the 70 cases in the immediate repair group, there was 7 (10%) surgical and 4 (5.7%) anaesthetic complications. The delayed group (169 infants) had 8 (4.7%) surgical and 6 (3.6%) anaesthetic complications. The incarceration rate after being discharged home was 4.1%. This group of infants had no anaesthetic or surgical complications. Length of hospital stay postoperatively was 1.43 days in the immediate group and 1.3 in the delayed group ( = .485).

CONCLUSION

Delayed repair, up to 2 months later, for uncomplicated infant hernia carries a small risk of incarceration but does not increase the rate of strangulation or other complications.

背景

婴儿腹股沟疝的潜在绞窄是其紧急修复的主要指征。缺乏手术时间会延迟修复并延长住院时间。我们报告了一系列患有单纯疝的患者，他们被送回家中，在稍后阶段进行选择性手术，并评估了这种方法的结果。

方法

对 2010 年 1 月至 2015 年 6 月期间所有患有腹股沟疝的婴儿进行了回顾性审计。排除了记录不完整和在一岁生日后接受手术的婴儿。确定了两组；对患有单纯疝的婴儿进行立即手术，对患有单纯疝的婴儿进行延迟手术。记录了延迟组在间隔期间的嵌顿/绞窄发生率，并对两组之间的围手术期和麻醉并发症以及术后住院时间进行了比较。

结果

从诊断到修复的平均时间延迟为 8.78 周。在等待修复期间，延迟组的疝没有一个发生绞窄。两组之间的围手术期并发症无显著差异。在立即修复组的 70 例病例中，有 7 例（10%）手术和 4 例（5.7%）麻醉并发症。延迟组（169 例婴儿）有 8 例（4.7%）手术和 6 例（3.6%）麻醉并发症。出院回家后的嵌顿率为 4.1%。这组婴儿没有麻醉或手术并发症。术后住院时间在立即组为 1.43 天，在延迟组为 1.3 天（=0.485）。