Li Yanyi, Jin Zhu, Tang Chengyan, Gong Yuan, Huang Lu, Du Qing, Xia Xinrong, Zhu Daiwei, Zhou Wankang, Li Zeping, Wang Weiao, Liu Yuanmei, Zheng Zebing
Department of Pediatric Surgery, Children Hospital of Guizhou Province, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.
Front Pediatr. 2024 Dec 23;12:1509895. doi: 10.3389/fped.2024.1509895. eCollection 2024.
The purpose of this study was to compare the outcomes of Trans-umbilical single-port laparoscopic complete extraperitoneal closure (LCEC) and laparoscopic intracorporeal closure (LIC) for inguinal hernia by analysis of follow-up data over 5 years.
In this prospective randomized controlled trial, 524 children with inguinal hernia were randomly assigned to undergo LCEC or LIC between August 2016 and December 2017. The primary outcome measures were the success and recurrence rates. The secondary outcome measures were operative time; length of hospital stay; postoperative pain score; and incidence of postoperative complications, including rates of wound infection, stitch abscess, and testicular atrophy.
Primary analysis of the 227 patients in the LIC group and 215 patients in the LCEC group revealed that in the LCEC group, the success rate of was significantly higher in LCEC group (96.7% vs. 90.3%, < .05) and the length of hospital stay was significantly shorter ( < .05) than those of the LIC group. Neither the recurrence rate ( > .05) nor the operative time ( > .05) of the groups significantly differed. The pain scores at postoperative 12 and 24 h were significantly lower in the LCEC group than in the LIC group ( < .05). The incidence rates of wound infection (0.93% vs. 5.7%, < .05) and stitch abscess (1.4% vs. 7.0%, < .05) were significantly lower in the LCEC group than in the LIC group. No testicular atrophy occurred in either group.
LCEC is associated with better clinical success and fewer postoperative complications for repair of pediatric inguinal hernia compared with LIC.
本研究旨在通过分析5年的随访数据，比较经脐单孔腹腔镜完全腹膜外修补术（LCEC）和腹腔镜体内修补术（LIC）治疗腹股沟疝的效果。
在这项前瞻性随机对照试验中，2016年8月至2017年12月期间，524例腹股沟疝患儿被随机分配接受LCEC或LIC治疗。主要观察指标为成功率和复发率。次要观察指标为手术时间、住院时间、术后疼痛评分以及术后并发症的发生率，包括伤口感染率、缝线脓肿率和睾丸萎缩率。
对LIC组的227例患者和LCEC组的215例患者进行的初步分析显示，LCEC组的成功率显著高于LIC组（96.7%对90.3%，P<0.05），住院时间显著短于LIC组（P<0.05）。两组的复发率（P>0.05）和手术时间（P>0.05）均无显著差异。LCEC组术后12小时和24小时的疼痛评分显著低于LIC组（P<0.05）。LCEC组的伤口感染发生率（0.93%对5.7%，P<0.05）和缝线脓肿发生率（1.4%对7.0%，P<0.05）均显著低于LIC组。两组均未发生睾丸萎缩。
与LIC相比，LCEC治疗小儿腹股沟疝具有更好的临床成功率和更少的术后并发症。
