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腹腔镜疝囊横断体内结扎术:与小儿年龄组开放疝修补术的比较

Laparoscopic Hernia Sac Transection With Intracorporeal Ligation: A Comparison With Open Hernia Repair in the Pediatric Age Group.

作者信息

Thakur Nancy, Tripathi Rakesh K, Singh Pawan K, Verma Shraddha, Maurya Rajesh K, Gupta Ayushya

机构信息

Department of General Surgery, Ganesh Shankar Vidhyarthi Memorial Medical College, Kanpur, IND.

出版信息

Cureus. 2024 Dec 13;16(12):e75633. doi: 10.7759/cureus.75633. eCollection 2024 Dec.

Abstract

Background and objective Inguinal hernia in children results from a failure of the processus vaginalis (PV) to close, leading to herniation. Surgical repair is necessary to prevent complications in this patient population. This study aimed to compare the outcomes between laparoscopic herniotomy (LH) and open herniotomy (OH) in pediatric patients with inguinal hernia. Methods This prospective study included 80 children diagnosed with inguinal hernia between January 2023 and June 2024. Patients aged 1-12 years were classified into two groups: 38 underwent LH, and 42 received OH. Postoperative outcomes, including operative time, pain, hospital stay, and complications, were evaluated. Statistical analysis was performed using descriptive statistics, with a p-value <0.05 considered significant. The t-test, chi-square test, and arithmetic mean with standard deviation (SD) were used for data analysis. Results The mean operative time was significantly longer for LH (97.89 ±18.2 minutes) compared to OH (31.14 ±8.3 minutes) (p<0.001). However, pain assessment revealed no significant difference between the groups (p=0.776). Hospital stay was longer for LH patients, who were discharged on day two, compared to day one for OH patients (p=0.001). No significant differences were observed in surgical site infection (SSI) rates (p=0.090) or return to school (p=0.857). Conclusions Laparoscopic and open hernia repair are comparable in terms of postoperative pain, SSI rates, and return to normal activities. However, OH offers advantages in terms of reduced operative time and shorter hospital stays. Further studies, including randomized controlled trials, are needed to exclude selection bias and provide deeper insights into the topic.

摘要

背景与目的 小儿腹股沟疝是由鞘状突(PV)闭合失败导致疝形成。对于该患者群体,手术修复是预防并发症所必需的。本研究旨在比较小儿腹股沟疝患者腹腔镜疝修补术(LH)与开放疝修补术(OH)的疗效。方法 这项前瞻性研究纳入了2023年1月至2024年6月期间诊断为腹股沟疝的80名儿童。1至12岁的患者分为两组:38例行LH,42例行OH。评估术后结果,包括手术时间、疼痛、住院时间和并发症。采用描述性统计进行统计分析,p值<0.05被认为具有统计学意义。使用t检验、卡方检验和带标准差(SD)的算术平均值进行数据分析。结果 LH组的平均手术时间(97.89±18.2分钟)明显长于OH组(31.14±8.3分钟)(p<0.001)。然而,疼痛评估显示两组之间无显著差异(p=0.776)。LH组患者的住院时间更长,LH组患者在术后第二天出院,而OH组患者在术后第一天出院(p=0.001)。手术部位感染(SSI)率(p=0.090)或返校情况(p=0.857)无显著差异。结论 腹腔镜疝修补术和开放疝修补术在术后疼痛、SSI率和恢复正常活动方面具有可比性。然而,OH在减少手术时间和缩短住院时间方面具有优势。需要进一步的研究,包括随机对照试验,以排除选择偏倚并对该主题提供更深入的见解。

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Laparoscopic pediatric inguinal hernia repair: a controlled randomized study.腹腔镜小儿腹股沟疝修补术:一项对照随机研究。
J Pediatr Surg. 2017 Oct;52(10):1539-1544. doi: 10.1016/j.jpedsurg.2017.07.003. Epub 2017 Jul 13.

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