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经皮内环缝合修补术治疗小儿腹股沟疝:714 例患者的回顾性队列研究,随访时间至少 3 年。

Percutaneous Internal Ring Suturing for Inguinal Hernia Repair in Children: Retrospective Cohort of 714 Patients with Minimum 3-Year Follow-Up.

机构信息

Department of Pediatric Surgery, Maltepe University Faculty of Medicine, Istanbul 34857, Turkey.

Department of Pediatric Surgery, Istanbul Sehit Prof. Dr. Ilhan Varank Research and Training Hospital, University of Health Sciences Faculty of Medicine, Istanbul 34764, Turkey.

出版信息

Medicina (Kaunas). 2024 Jul 15;60(7):1137. doi: 10.3390/medicina60071137.

Abstract

: Despite numerous described techniques, laparoscopy has yet to replace open surgery as the gold standard for inguinal hernia (IH) repair in children. This may be due to many variables, including the lack of long-term follow-up and concern for increased recurrence. In this study, we present our long-term follow-up data on children undergoing percutaneous internal ring suturing (PIRS) for IH repair. : This retrospective cohort study included children who underwent PIRS for IH between May 2013 and May 2021 at three tertiary care institutions, with at least three years of follow-up. Age at surgery, side of IH, presence of contralateral patent processus vaginalis, surgical and anesthesia time, and complications were noted. Parents were contacted to enquire about long-term complications, such as recurrence. : Long-term follow-up (average 6.9 ± 2.3 years) was available for 714 patients. For unilateral and bilateral procedures, the average surgical time was 13.6 ± 5.4 and 19.9 ± 3.0, and the average anesthesia time was 27.7 ± 12.9 and 33.9 ± 14.1 min, respectively. Complications were seen in 0.84% of patients and 1.2% of procedures, and recurrence was observed in 0.98% of patients and 0.78% of procedures. : Our study, with a nearly 7-year follow-up, provides substantial evidence that PIRS is a safe and effective technique for IH repair in children, with low recurrence and complication rates. Despite the study's retrospective nature and limited sample size, it contributes valuable data supporting the use of PIRS in pediatric IH repair.

摘要

尽管已经有许多描述性的技术,但腹腔镜手术尚未取代开放式手术成为儿童腹股沟疝 (IH) 修复的金标准。这可能是由于许多变量,包括缺乏长期随访和对复发增加的担忧。在这项研究中,我们介绍了我们对接受经皮内环缝合术 (PIRS) 治疗 IH 儿童进行的长期随访数据。

这项回顾性队列研究包括 2013 年 5 月至 2021 年 5 月在三家三级医疗机构接受 PIRS 治疗 IH 的儿童,随访时间至少 3 年。记录了手术时的年龄、IH 的侧别、对侧未闭的阴道精索、手术和麻醉时间以及并发症。联系家长询问长期并发症,如复发。

714 名患者获得了长期随访(平均 6.9 ± 2.3 年)。对于单侧和双侧手术,平均手术时间分别为 13.6 ± 5.4 和 19.9 ± 3.0 分钟,平均麻醉时间分别为 27.7 ± 12.9 和 33.9 ± 14.1 分钟。分别有 0.84%的患者和 1.2%的手术出现并发症,0.98%的患者和 0.78%的手术出现复发。

我们的研究随访时间近 7 年,提供了充分的证据表明 PIRS 是一种安全有效的儿童 IH 修复技术,复发和并发症发生率低。尽管该研究具有回顾性和样本量有限的性质,但它提供了有价值的数据,支持在小儿 IH 修复中使用 PIRS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ee0/11279132/b4c3f169cfdb/medicina-60-01137-g001.jpg

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