Department of General Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nanlishi St, Xicheng District, Beijing, 100045, China.
BMC Surg. 2021 Feb 1;21(1):67. doi: 10.1186/s12893-020-01039-5.
Congenital primary inguinal hernia is a common condition among children. Although much literature regarding inguinal hernia is available, large scale analysis are few, and rarely do they expand on gender difference or incarcerated hernias.
Patients with unilateral or bilateral inguinal hernia who were admitted to our hospital and received open inguinal hernia repair (OIHR) or laparoscopic inguinal hernia repair (LIHR) under general anesthesia were included. LIHR was performed using single-site laparoscopic percutaneous extraperitoneal closure (SLPEC). Medical records were retrospectively collected and analyzed.
A total of 12,190 patients were included in this study. The ratio of male to female was 4.8:1. There was a total of 10,646 unilateral hernias (87.3%) and 1544 bilateral hernias (12.7%), with a corresponding ratio of 6.9:1. 12,444 hernia repair surgeries, 11,083 (89.1%) OIHR and 1361 (10.9%) LIHR, were held. OIHR had a shorter operative time than LIHR for all unilateral and female bilateral repair, unlike for bilateral male repair. There was no difference between OIHR and LIHR for ipsilateral recurrent hernia in males. There was a difference between OIHR and LIHR for metachronous contralateral hernia. Incarcerated inguinal hernia was associated with longer operative time, hospital stay and higher hospital costs. Females and patients under 1 year were more likely to present with incarcerated hernia.
OIHR should be considered for male patients, especially for unilateral and complete inguinal hernia. LIHR is highly recommended for female patients. For incarcerated hernia, attention should be paid to patients under 1 year old, as they can be 60 times more susceptible, and females. Surgeons should also be aware of ovary hernias in females.
先天性腹股沟疝是儿童的常见疾病。尽管有很多关于腹股沟疝的文献，但大规模的分析很少，而且很少有文献对性别差异或嵌顿疝进行扩展分析。
本研究纳入了在我院接受全身麻醉下行开放式腹股沟疝修补术（OIHR）或腹腔镜腹股沟疝修补术（LIHR）的单侧或双侧腹股沟疝患者。LIHR 采用单部位腹腔镜经皮腹膜外闭合术（SLPEC）。回顾性收集并分析了病历资料。
本研究共纳入 12190 例患者。男女比例为 4.8:1。共有 10646 例单侧疝（87.3%）和 1544 例双侧疝（12.7%），相应的比例为 6.9:1。共行 12444 例疝修补术，其中 11083 例（89.1%）为 OIHR，1361 例（10.9%）为 LIHR。OIHR 在所有单侧和女性双侧修补术中的手术时间均短于 LIHR，但对于双侧男性修补术则相反。OIHR 和 LIHR 治疗男性同侧复发性疝时无差异。OIHR 和 LIHR 治疗男性同期对侧疝时存在差异。嵌顿性腹股沟疝与手术时间较长、住院时间较长和住院费用较高有关。女性和 1 岁以下患者更易发生嵌顿疝。
OIHR 应考虑用于男性患者，尤其是单侧和完全性腹股沟疝。LIHR 强烈推荐用于女性患者。对于嵌顿疝，应注意 1 岁以下患者，因为他们的易患性是普通人群的 60 倍，且女性患者更易发生嵌顿疝。外科医生还应注意女性的卵巢疝。
