Department of Pediatric Surgery and Kawaguchi Municipal Medical Center, Kawaguchi, Japan.
Division of Pediatric Surgery, Department of Surgery, The Jikei University, School of Medicine, Tokyo, Japan.
J Laparoendosc Adv Surg Tech A. 2023 Aug;33(8):807-813. doi: 10.1089/lap.2022.0581. Epub 2023 Apr 22.
No studies have directly compared postoperative umbilical port site (UPS)-related complications between transumbilical and periumbilical incisions (TUI and PUI) after laparoscopic surgery in children. We conducted a retrospective review of 324 children of ≤15 years of age who underwent laparoscopic repair (LR) for inguinal hernia, via either a TUI or PUI, between 2010 and 2020. UPS-related complications, such as wound infection and umbilical deformity, were compared between TUI and PUI. We also investigated the risk factors for the development of UPS-related complications after LR. TUIs and PUIs were used for 228 and 96 children, respectively. The incidence rates of postoperative wound infection and umbilical deformity in the PUI group were higher in comparison to the TUI group; although not to a statistically significant extent (7.3% versus 5.3%, = .451, 6.3% versus 4.8%, = .593). One case of incisional hernia at the UPS was seen in the TUI group. In the univariate analysis, sex, age, weight for age Z-score, nutrition status, insertion and closure time, total operative time, American Society of Anesthesiologists score, blood loss, and comorbidities were not significantly associated with the development of UPS-related complications after LR. The incidence of UPS-related complications in TUI and PUI was not significantly different. Due to the low incidence of UPS-related complications, it was difficult to draw conclusions regarding contributing factors; however, meticulous care should be taken to avoid UPS-related complications when closing the UPS (Ethical approval No. 2019-24).
尚无研究直接比较经脐和脐周切口(TUI 和 PUI)腹腔镜手术后脐部切口相关并发症。我们回顾性分析了 2010 年至 2020 年间接受腹腔镜腹股沟疝修补术(LR)的≤15 岁儿童 324 例,其中 TUI 组 228 例,PUI 组 96 例。比较了 TUI 和 PUI 组脐部切口相关并发症(如切口感染和脐部畸形)的发生率。还调查了 LR 后脐部切口相关并发症的危险因素。TUI 和 PUI 组术后切口感染和脐部畸形的发生率分别为 5.3%和 4.8%(P=0.593),6.3%和 7.3%(P=0.451)。TUI 组有 1 例脐部切口疝。单因素分析显示,LR 后脐部切口相关并发症的发生与性别、年龄、年龄体重 Z 评分、营养状况、插入和关闭时间、总手术时间、美国麻醉医师协会评分、出血量和并存疾病无关。TUI 和 PUI 组脐部切口相关并发症的发生率无显著差异。由于脐部切口相关并发症的发生率较低,难以得出相关因素的结论;但在关闭脐部切口时应格外小心,以避免脐部切口相关并发症(伦理批准号:2019-24)。