Tímár Ágnes Eszter, Bénes Dalma, Terebessy András, Fadgyas Balázs
Heim Pál National Pediatric Institute, Üllői Út 86, Budapest, 1089, Hungary.
Centre for Translational Medicine, Semmelweis University, Üllői Út 26, Budapest, 1085, Hungary.
Pediatr Surg Int. 2024 Dec 24;41(1):45. doi: 10.1007/s00383-024-05943-2.
The most common surgical intervention in childhood is inguinal hernioplasty. The advantage of laparoscopic approach is still questionable, therefore our aim was to compare open hernia repair (OHR) and PIRS (Percutaneous Internal Ring Suturing) technique at the authors' institute.
An observational retrospective cohort study was conducted between 2013 and 2021. Patients were included with hernioplasties under 18 years. The number of contralateral patent processus vaginalis, length of hospital stay, complications and recurrences were analysed.
1,072 surgeries were performed (OHR: 836, PIRS: 236) in 959 patients with the mean age of 4.2 years. During the study period 86 incarcerated hernias were treated: 85/86 following successful reduction with postponed surgery (77 open and eight PIRS) and 1/86 acute (open) surgery. Only six complications (OHR: 5, PIRS: 1, p = 0.86) and 22 recurrences were registered (open:15, PIRS: 7, p = 0.22). The average length of hospital stay was 1.13 days (OHR: 1.3, PIRS: 1.13 days, p = 0.82). PIRS identified contralateral patent processus vaginalis in 22.45% of cases initially diagnosed as unilateral.
Our findings indicate that both techniques are equally safe, with no statistically significant differences observed in terms of hospital stay duration, recurrence rates, or complication rates.
儿童期最常见的外科手术是腹股沟疝修补术。腹腔镜手术方法的优势仍存在疑问，因此我们的目的是在作者所在机构比较开放疝修补术（OHR）和经皮内环缝合术（PIRS）。
2013年至2021年进行了一项观察性回顾性队列研究。纳入18岁以下接受疝修补术的患者。分析对侧鞘突未闭的数量、住院时间、并发症和复发情况。
对959例平均年龄4.2岁的患者进行了1072例手术（OHR：836例，PIRS：236例）。在研究期间，治疗了86例嵌顿疝：86例中有85例在成功复位后延期手术（77例开放手术，8例PIRS手术），1例进行急诊（开放）手术。仅记录到6例并发症（OHR：5例，PIRS：1例，p = 0.86）和22例复发（开放手术：15例，PIRS：7例，p = 0.22）。平均住院时间为1.13天（OHR：1.3天，PIRS：1.13天，p = 0.82）。PIRS在最初诊断为单侧的病例中发现22.45%的对侧鞘突未闭。
我们的研究结果表明，两种技术同样安全，在住院时间、复发率或并发症发生率方面未观察到统计学上的显著差异。
