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女童腹股沟疝的单孔腹腔镜疝修补术:与开放修补术的比较

Single-site laparoscopic burnia for inguinal hernias in girls: comparison with open repair.

作者信息

Duh Yih-Cherng, Chang Paul Chia-Yu, Huang Hsuan, Fu Yu-Wei, Hsu Yao-Jen, Wei Chin-Hung, Shen Ming-Hung

机构信息

Division of Pediatric Surgery, Department of Surgery, Mackay Memorial Hospital, Hsinchu, Taiwan.

Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.

出版信息

Surg Endosc. 2021 Jan;35(1):471-475. doi: 10.1007/s00464-020-07983-w. Epub 2020 Sep 23.

Abstract

BACKGROUND

Burnia is a suturless repair for inguinal hernias in girls. It is performed under laparoscopy by grabbing the sac, inverting it into the peritoneal cavity, and cauterizing. The aim of this study is to report our experience with single-site laparoscopic burnia (BURNIA) and compare them with open repair (OPEN).

METHODS

With IRB approval, pediatric female patients younger than 18 years of age who underwent inguinal hernia repair between January 2015 and December 2017 were enrolled. Medical records were retrospectively reviewed. The patients were divided into two groups, BURNIA and OPEN.

RESULTS

198 patients were included. In BURNIA, 49 patients underwent bilateral repairs, and 50 patients underwent 51 unilateral repairs (one patient had metachronous contralateral hernia). In OPEN, 27 patients underwent bilateral repairs, and 72 patients underwent 77 unilateral repairs (five patients had metachronous contralateral hernias). The mean age of BURNIA was similar to OPEN for bilateral repairs (49.1 ± 36.6 vs. 43.7 ± 26.4 months, p = 0.46), but significantly older for unilateral repairs (54.6 ± 29.8 vs. 29.0 ± 31.4, p < 0.01). The mean operation time of BUNIA was similar to OPEN for bilateral repairs (24.2 ± 7.6 vs. 22.4 ± 8.6 min, p = 0.35), but significantly longer for unilateral repairs (19.2 ± 7.0 vs, 13.6 ± 8.8 min, p < 0.01). The mean follow-up duration of BURNIA was significantly shorter than OPEN for bilateral and unilateral repairs, respectively (32.5 ± 8.8 vs. 45.4 ± 4.8 months, p < 0.01) (30.2 ± 8.8 vs. 39.1 ± 9.6 months, p < 0.01). No conversion was required in BURNIA. There were no complications and no recurrence in all patients.

CONCLUSIONS

Single-site laparoscopic burnia is technically feasible, and as safe and effective as open inguinal hernia repair.

摘要

背景

Burnia术是一种用于女童腹股沟疝的无缝合修补术。该手术通过腹腔镜抓取疝囊,将其翻转至腹腔内并烧灼来完成。本研究的目的是报告我们单孔腹腔镜Burnia术(BURNIA)的经验,并与开放修补术(OPEN)进行比较。

方法

经机构审查委员会批准,纳入2015年1月至2017年12月期间接受腹股沟疝修补术的18岁以下儿科女性患者。对病历进行回顾性分析。将患者分为两组,即BURNIA组和OPEN组。

结果

共纳入198例患者。在BURNIA组中,49例患者接受双侧修补,50例患者接受51例单侧修补(1例患者为异时性对侧疝)。在OPEN组中,27例患者接受双侧修补,72例患者接受77例单侧修补(5例患者为异时性对侧疝)。BURNIA组双侧修补的平均年龄与OPEN组相似(49.1±36.6个月 vs. 43.7±26.4个月,p = 0.46),但单侧修补时BURNIA组年龄显著更大(54.6±29.8个月 vs. 29.0±31.4个月,p < 0.01)。BURNIA组双侧修补的平均手术时间与OPEN组相似(24.2±7.6分钟 vs. 22.4±8.6分钟,p = 0.35),但单侧修补时显著更长(19.2±7.0分钟 vs. 13.6±8.8分钟,p < 0.01)。BURNIA组双侧和单侧修补的平均随访时间分别显著短于OPEN组(32.5±8.8个月 vs. 45.4±4.8个月,p < 0.01)(30.2±8.8个月 vs. 39.1±9.6个月,p < 0.01)。BURNIA组无需中转手术。所有患者均无并发症且无复发。

结论

单孔腹腔镜Burnia术在技术上是可行的,与开放腹股沟疝修补术一样安全有效。

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