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腹腔镜与开放手术治疗儿童腹股沟疝的对比:一项随机对照试验的荟萃分析

Laparoscopic versus open herniorrhaphy for children with inguinal hernia: A meta-analysis of randomized controlled trials.

作者信息

Liu Guoqing, Zhang Wenxian, Zhou Jianfeng, Sun Bin, Jiang Bin, Wang Hao

机构信息

Department of General Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Medicine (Baltimore). 2020 Aug 14;99(33):e21557. doi: 10.1097/MD.0000000000021557.

Abstract

PURPOSE

The aim of this study was to compare the effectiveness between laparoscopic herniorrhaphy (LH) and open herniorrhaphy (OH) in children with inguinal hernia.

METHODS

PubMed, EmBase, and the Cochrane library were searched to select trials from their inception till April 2019. The summary of relative risks (RRs) and weighted mean differences (WMDs) with corresponding 95% confidence intervals (CIs) were employed to evaluate the treatment effectiveness between LH and OH.

RESULTS

Six randomized controlled trials (RCTs) including a total of 594 children were selected. No significant differences were observed between LH and OH regarding the risk of postoperative complications. However, LH significantly reduced the risk of major postoperative complications when compared with OH. Moreover, LH showed association with a shorter operative time in bilateral inguinal hernia when compared with OH, whereas no significant difference between groups for unilateral inguinal hernia. Finally, children who received LH showed association with longer time to discharge than those who received OH, whereas no significant difference was observed between the groups for time to resume full activity.

CONCLUSIONS

These findings suggested that children who received LH had protection against major postoperative complications than those who received OH. Moreover, children who received LH had shorter operative time, and longer time to discharge.

摘要

目的

本研究旨在比较腹腔镜疝修补术(LH)与开放疝修补术(OH)治疗小儿腹股沟疝的疗效。

方法

检索PubMed、EmBase和Cochrane图书馆,以选择从创刊至2019年4月的试验。采用相对危险度(RRs)和加权均数差(WMDs)及其相应的95%置信区间(CIs)来评估LH和OH之间的治疗效果。

结果

共纳入6项随机对照试验(RCTs),包括594例儿童。LH和OH在术后并发症风险方面无显著差异。然而,与OH相比,LH显著降低了术后主要并发症的风险。此外,与OH相比,LH在双侧腹股沟疝手术时间上更短,而在单侧腹股沟疝组间无显著差异。最后,接受LH治疗的儿童出院时间比接受OH治疗的儿童更长,而在恢复完全活动时间上两组间无显著差异。

结论

这些发现表明,接受LH治疗的儿童比接受OH治疗的儿童在术后主要并发症方面有更好的防护。此外,接受LH治疗的儿童手术时间更短,出院时间更长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6132/7437831/f2380d394df4/medi-99-e21557-g006.jpg

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