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小儿腹腔镜辅助经皮腹股沟疝修补术的长期疗效:10 年经验。

Long-term outcomes of pediatric laparoscopic needled-assisted inguinal hernia repair: A 10-year experience.

机构信息

Medical University of South Carolina, Charleston, SC.

Nemours Children's Hospital, Orlando, FL.

出版信息

J Pediatr Surg. 2021 Jan;56(1):121-125. doi: 10.1016/j.jpedsurg.2020.09.022. Epub 2020 Nov 4.

Abstract

PURPOSE

Laparoscopic inguinal hernia repair (LIHR) has gained wide acceptance over the past decade, although studies with longer term follow-up are lacking. We present one of the largest cohorts of children undergoing laparoscopic needle-assisted repair (LNAR) with long-term follow-up.

METHODS

A clinical quality database was maintained for children ≤14 years of age who underwent laparoscopic needle-assisted repair between 2009 and 2017 with review of follow-up through 2019. De-identified data was reviewed.

RESULTS

1023 patients with 1457 LNAR were included during the 10-year period. Mean age at surgery was 2.56 years (2 days to14 years). The overall hernia recurrence rate was 0.75% (11/1457). A total of four postoperative hydroceles required intervention. Preterm infant repair done <60w post conceptional age had a significantly lower recurrence rate (0.63%) than other patients (0.82%) (p < 0.01). 64.2% of patients had clinical follow-up over a period of 11 years with a mean follow-up of 5.97 years.

CONCLUSION

We present a large cohort study of consecutive pediatric laparoscopic hernia repairs followed over an 11-year period. LNAR is safe and effective for term and preterm patients with similar complication rates to other techniques, including open repair. Additionally, our results suggest that preterm infants may have superior outcomes with this method.

LEVEL OF EVIDENCE

Level III - Retrospective Comparative Study.

摘要

目的

腹腔镜腹股沟疝修补术(LIHR)在过去十年中得到了广泛的认可,尽管缺乏长期随访的研究。我们报告了其中一组最大的儿童腹腔镜辅助经皮缝合修补术(LNAR)长期随访队列。

方法

对 2009 年至 2017 年间接受腹腔镜辅助经皮缝合修补术的≤14 岁儿童进行了临床质量数据库维护,并在 2019 年对随访情况进行了回顾。审查了去标识数据。

结果

在 10 年期间,共有 1023 例患儿(1457 例 LNAR)纳入研究。手术时的平均年龄为 2.56 岁(2 天至 14 岁)。总的疝复发率为 0.75%(11/1457)。共有 4 例术后鞘膜积液需要干预。早产婴儿在受孕后 60 周内进行手术的复发率明显低于其他患者(0.63%比 0.82%)(p<0.01)。64.2%的患者在 11 年的时间里进行了临床随访,平均随访时间为 5.97 年。

结论

我们报告了一项大型连续儿童腹腔镜疝修补术队列研究,随访时间超过 11 年。LNAR 对足月和早产患儿均安全有效,与其他技术(包括开放修补术)相比,并发症发生率相似。此外,我们的结果表明,这种方法可能对早产儿有更好的效果。

证据水平

III 级-回顾性比较研究。

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