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比较腹腔镜经皮腹膜外闭合术(LPEC)与开放手术治疗 5 岁以下儿童腹股沟疝的疼痛。

Comparison of pain between laparoscopic percutaneous extraperitoneal closure (LPEC) and open procedure for inguinal hernias in children below 5 years of age.

机构信息

Department of Pediatric Surgery, Showa University School of Medicine, 1-5-8, Hatanaodai, Shinagawa-Ku, Tokyo, 142-8555, Japan.

出版信息

Pediatr Surg Int. 2024 Nov 7;40(1):294. doi: 10.1007/s00383-024-05875-x.

Abstract

PURPOSE

The laparoscopic approach (LA) for repairing inguinal hernias (IH), especially laparoscopic extraperitoneal percutaneous closure (LPEC) has become popular minimally invasive surgical technique. However, invasiveness is difficult to evaluate in children of < 5 years of age, as they cannot adequately express their pain. The current study utilized a pain scoring system compare pain in patients of < 5 years of age who were treated by LA or traditional open approach (OA).

METHODS

The records of 74 IH patients of < 5 years of age who underwent surgery in our hospital between January 2022 and July 2023 were reviewed. Revised Face, Legs, Activity, Cry, and Consolability (FLACC) scores were used to quantitatively evaluate the degree of pain.

RESULTS

Forty-seven patients (mean age, 2.85 years) underwent treatment with an OA, and 27 patients (mean age, 2.37 years) underwent treatment with an LA. The FLACC scores in the OA and LA groups were 0.21 and 0.44, respectively. In a subanalysis by age groups, The FLACC scores in the OA and LA groups were 0.09 and 0.5 in patients of < 2 years of age, respectively, CONCLUSION: The reduced invasiveness of LA relative to OA did not minimize postoperative pain, especially in patients < 2 years of age.

摘要

目的

腹腔镜(LA)技术治疗腹股沟疝(IH),特别是腹腔镜经腹膜外穿刺闭合术(LPEC),已成为一种流行的微创外科技术。然而,对于年龄小于 5 岁的儿童,由于他们无法充分表达疼痛,手术的侵袭性很难评估。本研究采用疼痛评分系统比较了年龄小于 5 岁的患者接受 LA 或传统开放手术(OA)治疗的疼痛程度。

方法

回顾 2022 年 1 月至 2023 年 7 月在我院接受手术的 74 例年龄小于 5 岁的 IH 患者的病历。采用修订后的面部、腿部、活动、哭泣和安慰评分(FLACC)量表对疼痛程度进行定量评估。

结果

47 例(平均年龄 2.85 岁)患者接受 OA 治疗,27 例(平均年龄 2.37 岁)患者接受 LA 治疗。OA 和 LA 组的 FLACC 评分分别为 0.21 和 0.44。在年龄亚组分析中,OA 和 LA 组年龄小于 2 岁的患者的 FLACC 评分分别为 0.09 和 0.5。

结论

与 OA 相比,LA 的侵袭性降低并没有使术后疼痛最小化,尤其是在年龄小于 2 岁的患者中。

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