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比较开放式修复和腹腔镜修复与 PIRS 方法治疗儿童鞘膜积液的结果。

Comparison of the results of open repair and laparoscopic repair with the PIRS method in the treatment of hydrocele in children.

机构信息

Ankara University Medical School, Department of Pediatric Surgery, Ankara, Turkey.

出版信息

Pediatr Surg Int. 2024 Feb 12;40(1):56. doi: 10.1007/s00383-024-05632-0.

Abstract

PURPOSE

Hydrocele is a result of intraperitoneal fluid filling into the scrotum through the patent processus vaginalis (PPV). While the traditional approach of pediatric hydrocele has been open repair (OR) for years, laparoscopic repair (LR) of hydrocele has been accepted worldwide after the proven efficacy of laparoscopy. The purpose is to compare the outcomes of both techniques in a single center.

METHODS

We retrospectively analyzed the clinical data of all the patients who underwent hydrocele repair from August 2016 to November 2022. In our center, the standard approach was OR in hydrocele until the November of 2021. Starting from this date, LR has begun to be preferred, as the experience has increased and its success has been observed. In the LR group, single-port percutaneous internal ring suturing technique was performed.

RESULTS

The data of 113 patients (OR 58.4% (n = 66), LR 41.6% (n = 47)) were collected. In preoperative examination, 12.4% (n = 14) patients were diagnosed as communicating and 87.6% (n = 99) non-communicating hydrocele. Intraoperatively, 65.5% (n = 74) patients were communicating and 34.5% (n = 39) were non-communicating. Total recurrence rate was 7% (n = 8). The OR group experienced a recurrence rate of 10.6% (n = 7), while the LR group experienced 2.12% (n = 1).

CONCLUSION

Laparoscopy may reveal intrabdominal connection of hydrocele better than open approach. It provides a high quality view of both inguinal rings and has the advantages of minimally invasive surgery.

摘要

目的

鞘膜积液是由于腹腔内液体通过未闭的鞘状突(PPV)进入阴囊而引起的。多年来,小儿鞘膜积液的传统治疗方法一直是开放修复(OR),但在腹腔镜技术被证实有效后,全球范围内开始接受腹腔镜修复(LR)。本研究旨在比较单中心两种技术的治疗效果。

方法

我们回顾性分析了 2016 年 8 月至 2022 年 11 月期间所有接受鞘膜积液修复的患者的临床资料。在我们中心,直到 2021 年 11 月,标准治疗方法一直是 OR。从那时起,随着经验的增加和疗效的观察,LR 开始被优先考虑。在 LR 组中,采用单孔经皮内环缝合技术。

结果

共收集了 113 例患者的数据(OR 58.4%(n=66),LR 41.6%(n=47))。术前检查中,12.4%(n=14)的患者被诊断为交通性鞘膜积液,87.6%(n=99)的患者为非交通性鞘膜积液。术中发现 65.5%(n=74)的患者为交通性鞘膜积液,34.5%(n=39)为非交通性鞘膜积液。总复发率为 7%(n=8)。OR 组的复发率为 10.6%(n=7),LR 组的复发率为 2.12%(n=1)。

结论

腹腔镜检查可能比开放手术更能发现鞘膜积液的腹腔内连接。它可以提供腹股沟环的高质量视图,具有微创外科的优点。

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