Ji Yi, Li Yanan, Zhang Xuepeng, Qiu Tong, Chen Siyuan, Xu Zhicheng
Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, China.
Pediatric Intensive Care Unit, Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China.
Front Pediatr. 2022 Mar 15;10:855537. doi: 10.3389/fped.2022.855537. eCollection 2022.
A new novel technique for pediatric inguinal hernia (PIH) repair, namely, transumbilical single-site laparoscopic intraperitoneal closure (TUSLIC) of the internal inguinal ring (IIR) with a single instrument, was introduced. The short-term follow-up of TUSLIC for PIH was compared with that of transabdominal multiple-site laparoscopic extraperitoneal closure (TAMLEC) for PIH.
Descriptive variables, perioperative clinical features, and short-term outcomes were retrospectively analyzed and compared between the patients who underwent TUSLIC and those who underwent TAMLEC.
In total, 289 patients were enrolled in this study. Of these, 190 patients received TUSLIC, and 99 patients received TAMLEC. The descriptive variables (including sex, age, weight, and preoperative diagnosis of patients) were comparable between the two groups (-values were 0.12, 0.71, 0.69, and 0.23, respectively). The mean operative times for unilateral hernia repair and bilateral hernia repairs in TAMLEC group were significantly less than those in TUSLIC group ( < 0.01). The values of surgical site infection, umbilical bleeding, testicular atrophy, iatrogenic ascent of the testis, and secondary hydrocele were not significantly different between the two groups. There were no suture granulomas, and recurrence occurred in TUSLIC group, though at a significantly lower rate than in TAMLEC group ( < 0.05).
TUSLIC is a feasible, safe, and reliable minimally invasive method for PIH. Compared with TAMLEC, TUSLIC has the advantages of minimized complications and a low recurrence rate.
一种用于小儿腹股沟疝（PIH）修补的新技术被引入，即经脐单部位腹腔镜腹腔内腹股沟内环（IIR）闭合术（TUSLIC），该技术使用单一器械。将TUSLIC治疗PIH的短期随访结果与经腹多部位腹腔镜腹膜外闭合术（TAMLEC）治疗PIH的短期随访结果进行比较。
对接受TUSLIC和TAMLEC治疗的患者的描述性变量、围手术期临床特征和短期结局进行回顾性分析和比较。
本研究共纳入289例患者。其中，190例患者接受了TUSLIC治疗，99例患者接受了TAMLEC治疗。两组患者的描述性变量（包括性别、年龄、体重和术前诊断）具有可比性（P值分别为0.12、0.71、0.69和0.23）。TAMLEC组单侧疝修补和双侧疝修补的平均手术时间显著短于TUSLIC组（P<0.01）。两组患者手术部位感染、脐部出血、睾丸萎缩、医源性睾丸上升和继发性鞘膜积液的值无显著差异。TUSLIC组未出现缝线肉芽肿，且有复发情况，但复发率显著低于TAMLEC组（P<0.05）。
TUSLIC是一种用于PIH的可行、安全且可靠的微创方法。与TAMLEC相比，TUSLIC具有并发症最少和复发率低的优点。
