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一项比较儿童腹腔镜与开放腹股沟疝修补术的研究:来自中国单一中心的回顾性研究。

A comparative study examining laparoscopic and open inguinal hernia repair in children: a retrospective study from a single center in China.

作者信息

Liu Jie, Wu XiongWei, Xiu WenLi, Hao XiWei, Zhao Jing, Wei Bin, Dong Qian

机构信息

Department of Pediatric Surgery, Affiliated Hospital of Qingdao University, Qingdao University, No. 16 Jiangsu Road, Shinan District, Qingdao, 266000, Shandong Province, China.

Department of Pediatric Surgery, Yijishan Hospital of Wannan Medical College, Wannan Medical College, Wuhu, 246400, Anhui Province, China.

出版信息

BMC Surg. 2020 Oct 19;20(1):244. doi: 10.1186/s12893-020-00912-7.

Abstract

BACKGROUND

Pediatric inguinal hernia (PIH) is a common disease in children. Laparoscopic hernia repair (LHR) has developed rapidly in recent years, but there are still different opinions compared with traditional open hernia repair (OHR). The purpose of this study was to compare the advantages and disadvantages of LHR and OHR in the treatment of pediatric inguinal hernia.

METHODS

We performed a retrospective review of all children (< 14 years) who underwent repair of inguinal hernia in the pediatric surgery center of the Affiliated Hospital of Qingdao University from January 2015 to December 2015. We collected the medical records of all the children and analyzed the clinical characteristics, operation-related information and follow-up.

RESULTS

In the OHR group, 202 cases underwent unilateral inguinal hernia repair, and 43 cases underwent bilateral inguinal hernia repair. In the LHR group, 168 cases underwent unilateral inguinal hernia repair, and 136 cases underwent bilateral inguinal hernia repair. There was a significant difference in the operation time between the two groups, but there were no significant differences in postoperative hospitalization time and incidence of ipsilateral recurrent hernia between the two groups. The incidence rates of metachronous contralateral hernia (MCH) and surgical site infection in LHR group were significantly lower than those in the OHR group.

CONCLUSION

Our study shows that compared with OHR, LHR has the advantages of concealed incision, minimal invasiveness, reduced operation time, detection of contralateral patent processus vaginalis, and reduced incidence of MCH. In conclusion, LHR is safe and effective in the treatment of pediatric indirect inguinal hernia.

摘要

背景

小儿腹股沟疝(PIH)是儿童常见疾病。近年来腹腔镜疝修补术(LHR)发展迅速,但与传统开放疝修补术(OHR)相比仍存在不同观点。本研究旨在比较LHR和OHR治疗小儿腹股沟疝的优缺点。

方法

我们对2015年1月至2015年12月在青岛大学附属医院小儿外科中心接受腹股沟疝修补术的所有儿童(<14岁)进行了回顾性研究。收集了所有儿童的病历,并分析了临床特征、手术相关信息及随访情况。

结果

OHR组中,202例行单侧腹股沟疝修补术,43例行双侧腹股沟疝修补术。LHR组中,168例行单侧腹股沟疝修补术,136例行双侧腹股沟疝修补术。两组手术时间有显著差异,但两组术后住院时间和同侧复发性疝发生率无显著差异。LHR组的异时性对侧疝(MCH)发生率和手术部位感染率显著低于OHR组。

结论

我们的研究表明,与OHR相比,LHR具有切口隐蔽、创伤小、手术时间缩短、能检测对侧鞘状突未闭及MCH发生率降低等优点。总之,LHR治疗小儿间接性腹股沟疝安全有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bbf/7574473/6621cb9909ec/12893_2020_912_Fig1_HTML.jpg

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