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腹腔镜经皮内环缝合与经典开放手术治疗儿童腹股沟疝的长期疗效比较。

Comparison of long-term outcomes of laparoscopic percutaneous internal ring suturing and classic open approach for inguinal hernia repair in children.

机构信息

Private Gebze Yuzyil Hospital, Gebze, Kocaeli, Turkiye.

出版信息

Ann R Coll Surg Engl. 2024 Nov;106(8):718-723. doi: 10.1308/rcsann.2024.0058. Epub 2024 Jul 25.

DOI:10.1308/rcsann.2024.0058
PMID:39051789
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11528400/
Abstract

INTRODUCTION

Inguinal hernia repair is one of the most common surgeries in children. Recently, the use of minimally invasive techniques for inguinal hernia repair has increased in children. Laparoscopic percutaneous internal ring suturing (PIRS) is a technique described for paediatric inguinal hernia repair. The primary objective of this study is to demonstrate the efficacy and reliability of PIRS in paediatric patients through a comparative analysis with an open method.

METHODS

Between January 2017 and June 2023, records of patients who underwent surgery for inguinal hernia were retrospectively reviewed. In total 126 patients were included in the study. They were divided into two groups: 33 patients underwent PIRS (group 1) and 93 patients underwent open repair (group 2). Operation time, cost and complications were compared.

RESULTS

The mean age of the 126 patients was 3.23 ± 2.4 years. The mean unilateral operative time was 25.13 ± 5.32min in group 1 and 30.28 ± 4.73min in group 2, and there was a statistically significant difference in operative time ( < 0.001). Two patients in group 1 underwent surgery owing to patent processus vaginalis, whereas three patients in group 2 underwent surgery owing to metachronous hernia. There were no major complications such as bleeding requiring surgical intervention or conversion to an open approach during surgery in group 1. No recurrent hernia was observed in any of the 126 patients.

CONCLUSIONS

PIRS offers a safe, easy-to-learn method with low complication rates. PIRS has a distinct advantage over open surgical repair because of its capacity to evaluate the contralateral inguinal ring.

摘要

引言

腹股沟疝修补术是儿童中最常见的手术之一。最近,儿童腹股沟疝修补术微创技术的应用有所增加。腹腔镜经皮内环缝合术(PIRS)是一种用于小儿腹股沟疝修补的技术。本研究的主要目的是通过与开放方法的比较分析,证明 PIRS 在小儿患者中的疗效和可靠性。

方法

回顾性分析 2017 年 1 月至 2023 年 6 月期间接受手术治疗的腹股沟疝患者的记录。共有 126 例患者纳入本研究。他们被分为两组:33 例患者接受 PIRS(组 1)和 93 例患者接受开放修复(组 2)。比较手术时间、费用和并发症。

结果

126 例患者的平均年龄为 3.23 ± 2.4 岁。组 1 的单侧手术时间平均为 25.13 ± 5.32min,组 2 的手术时间平均为 30.28 ± 4.73min,手术时间有统计学显著差异(<0.001)。组 1 中有 2 例患者因鞘突未闭而再次手术,组 2 中有 3 例患者因异时性疝而再次手术。组 1 术中无大出血等需手术干预或转为开放手术的严重并发症。126 例患者均无疝复发。

结论

PIRS 提供了一种安全、易于学习、并发症发生率低的方法。与开放手术修复相比,PIRS 具有明显的优势,因为它能够评估对侧腹股沟环。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4641/11528400/1040438f76cf/rcsann.2024.0058.01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4641/11528400/1040438f76cf/rcsann.2024.0058.01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4641/11528400/1040438f76cf/rcsann.2024.0058.01.jpg

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The history of inguinal hernia surgery.腹股沟疝手术的历史。
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Comparison of Laparoscopic Percutaneous Extraperitoneal Internal Ring Closure by Two-Hook Hernia Needle and Open Repair for Pediatric Inguinal Hernia.腹腔镜经皮腹膜外内环缝合术与开放修补术治疗小儿腹股沟疝的比较。
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