Li Shuan-Ling, Li Zong-Han, Xie Fang-Nan, Liang Yi-Yuan, Li Xian-Ling, Huang Liu-Ming
Department of Emergency Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Transl Pediatr. 2025 Apr 30;14(4):639-645. doi: 10.21037/tp-2024-541. Epub 2025 Apr 27.
The concurrent surgical treatment of acute appendicitis and inguinal hernia in pediatric patients, particularly in the presence of severe intra-abdominal infections, remains a topic of debate. The aim of this study was to assess the safety and efficacy of simultaneous laparoscopic surgery for complicated appendicitis combined with inguinal hernia in children.
A retrospective review was conducted on pediatric patients with complicated appendicitis associated with concurrent inguinal hernia treated between January 2016 to December 2022 at a tertiary care center. Patients were divided into two groups: those who underwent simultaneous hernia repair (simultaneous group) and those who received staged procedures (two-stage group). Demographic data, perioperative findings, and follow-up outcomes were analyzed.
A total of 40 patients were included in this analysis, with 29 patients in the simultaneous group and 11 in the two-stage group. No significant differences were observed between the two groups, except for a higher proportion of bilateral inguinal hernia in the simultaneous group. Operative time was longer in the simultaneous group compared to the two-stage group (specifically for primary appendectomy), though this difference was not statistically significant [84.0 (70.0; 105) 68.0 (57.5; 102) minutes, P=0.32]. The simultaneous group experienced a shorter hospital stay and a reduced duration of postoperative antibiotic use compared to the two-stage group [5.00 (4.00; 6.00) 6.00 (5.00; 9.00) days, P=0.056; 4.00 (3.00; 6.00) 5.00 (4.75; 8.00) days, P=0.04]. Over a follow-up period ranging from 11 to 66 months, postoperative complications were observed in only one patient from the two-stage group, with no recurrence of inguinal hernia in the simultaneous group.
Simultaneous laparoscopic treatment of acute appendicitis and inguinal hernia in pediatric patients appears to be a feasible, safe, and effective approach, even in cases involving complicated appendicitis with significant contamination.
小儿患者急性阑尾炎与腹股沟疝的同期手术治疗，尤其是在存在严重腹腔内感染的情况下，仍是一个有争议的话题。本研究的目的是评估小儿复杂阑尾炎合并腹股沟疝同期腹腔镜手术的安全性和有效性。
对2016年1月至2022年12月在一家三级医疗中心接受治疗的合并腹股沟疝的小儿复杂阑尾炎患者进行回顾性研究。患者分为两组：接受同期疝修补术的患者（同期组）和接受分期手术的患者（分期组）。分析人口统计学数据、围手术期结果和随访结果。
本分析共纳入40例患者，同期组29例，分期组11例。两组之间未观察到显著差异，除了同期组双侧腹股沟疝的比例较高。同期组的手术时间比分期组长（特别是初次阑尾切除术），尽管这种差异无统计学意义[84.0（70.0；105）对68.0（57.5；102）分钟，P = 0.32]。与分期组相比，同期组的住院时间更短，术后抗生素使用时间更短[5.00（4.00；6.00）对6.00（5.00；9.00）天，P = 0.056；4.00（3.00；6.00）对5.00（4.75；8.00）天，P = 0.04]。在11至66个月的随访期内，分期组仅1例患者出现术后并发症，同期组腹股沟疝无复发。
小儿急性阑尾炎与腹股沟疝的同期腹腔镜治疗似乎是一种可行、安全且有效的方法，即使在涉及伴有严重污染的复杂阑尾炎病例中也是如此。
