Son Tran N, Bao Hoang V, Van Nguyen T H, Hiep Pham D, Mai Duong V, Quyet Tran V
Department of Pediatric Surgery, Saint Paul Hospital, No 12 Chu Van An Street, Ba Dinh District, Hanoi, 100000, Vietnam.
Pediatr Surg Int. 2024 Jul 13;40(1):187. doi: 10.1007/s00383-024-05779-w.
To present our technical modifications of single incision laparoscopic percutaneous extraperitoneal closure (SILPEC) of the internal inguinal ring (IIR) for pediatric inguinal hernia (PIH).
The prospectively collected data of all children diagnosed with PIH undergoing SILPEC at our center from 2016 to 2023 were reviewed and divided into two groups for result comparison: Group A: before and Group B: after the implementation of full modifications. Our modifications included using a nonabsorbable monofilament suture, creating a peritoneal thermal injury at the internal inguinal ring (IIR), employing a cannula to ensure the suture at the IIR ligates only the peritoneum, and double ligation of the IIR in selected cases.
1755 patients in group A and in group B (1 month to 14 years old) were enrolled. There were no significant differences regarding baseline patient characteristics between the two groups. At a median follow-up of 40 months, the rate of recurrent CIH and subcutaneous stitch granuloma (SSG) was 2.3% and 1.5% in group A vs. 0% and 0% in group B (p < 0.001). There were no hydroceles, no ascended or atrophic testis.
Our SILPEC technical modifications can achieve zero recurrence and zero SSG for PIH.
介绍我们对小儿腹股沟疝（PIH）行单切口腹腔镜经皮腹膜外内环（IIR）闭合术（SILPEC）的技术改进。
回顾性分析2016年至2023年在本中心接受SILPEC治疗的所有诊断为PIH的儿童的前瞻性收集数据，并分为两组进行结果比较：A组：改进前，B组：全面改进后。我们的改进包括使用不可吸收单丝缝线、在腹股沟内环（IIR）处造成腹膜热损伤、使用套管确保IIR处的缝线仅结扎腹膜以及在选定病例中对IIR进行双重结扎。
A组和B组纳入了1755例患者（1个月至14岁）。两组患者的基线特征无显著差异。中位随访40个月时，A组复发性CIH和皮下缝线肉芽肿（SSG）的发生率分别为2.3%和1.5%，而B组为0%和0%（p < 0.001）。无鞘膜积液，无睾丸上升或萎缩。
我们的SILPEC技术改进可使PIH的复发率和SSG发生率为零。
