Liu Chao, Yan Dong, Li Xiang, Zhou Qi, Zhang Lei
Department of Pediatric Surgery, Qilu Hospital of Shandong University, Qingdao, 266035, China.
Department of Anesthesia, Qilu Hospital of Shandong University, 758 Hefei Road, Shibei District, Qingdao, 266035, Shandong Province, China.
Sci Rep. 2025 Aug 5;15(1):28507. doi: 10.1038/s41598-025-14321-4.
This is a retrospective clinical study that summarizes the clinical experience of single-port laparoscopic medial umbilical fold reinforcement surgery (SPLMUFRS) for pediatric giant inguinal hernia with the internal ring diameter greater than 1.5 centimeters. 147 children with inguinal hernia admitted to the Department of Pediatric Surgery, Qilu Hospital of Shandong University (Qingdao) from July 2019 to June 2023 were included in this study, including 124 males and 23 females. All patients were divided into Group A (n = 86) and Group B (n = 61) based on the last digit of their hospitalization number, with odd numbers included in Group A and even in Group B. Both groups underwent single-port laparoscopy, but the surgical methods were different. The primary outcome was the postoperative recurrence rate, and secondary outcomes were the percentage of metachronous indirect inguinal hernia (MCIH), surgical time, and pain score at hernia needle puncture site. The average age of Group A was 61.5 ± 23.8 (13-148) months, and the average weight was 22 (18-27) Kg. The average age of Group B was 57.7 ± 27.2 (17-159) months, and the average weight was 22 (19-27) Kg. There was no statistically significant difference in age and weight between the two groups. During the laparoscopy, a total of 147 unclosed internal rings were found that had a diameter greater than 1.5 cm (86 in Group A and 61 in Group B), and they were treated with SPLMUFRS after single-port laparoscopic percutaneous extraperitoneal closure (SPLPEC), with Group A underwent V-shaped fixation method and Group B underwent U-shaped fixation method. The average surgical time for Group A was 11.8 ± 1.9 (9-16) minutes, while Group B was 13.8 ± 2.6 (9-20) minutes, and the difference in surgical time between the two groups was statistically significant (P<0.001). All patients underwent surgery smoothly. All patients were followed up for 1-3 years after surgery, and no patients experienced postoperative recurrence. Several patients experienced short-term pain at the puncture site or temporary hydrocele, which improved significantly after conservative observation. Although there are differences in the surgical methods and surgical time between the two types of SPLMUFRS, they are safe and reliable for pediatric giant inguinal hernia with the internal ring diameter greater than 1.5 cm, and can reduce the postoperative recurrence rate.
这是一项回顾性临床研究，总结了单孔腹腔镜内侧脐襞加强修补术（SPLMUFRS）治疗内环直径大于1.5厘米的小儿巨大腹股沟疝的临床经验。山东大学齐鲁医院（青岛）小儿外科2019年7月至2023年6月收治的147例腹股沟疝患儿纳入本研究，其中男124例，女23例。所有患者根据住院号末位数字分为A组（n = 86）和B组（n = 61），住院号末位数字为奇数的纳入A组，偶数的纳入B组。两组均行单孔腹腔镜手术，但手术方法不同。主要结局指标为术后复发率，次要结局指标为异时性腹股沟斜疝（MCIH）发生率、手术时间及疝针穿刺部位疼痛评分。A组平均年龄为61.5±23.8（13 - 148）个月，平均体重为22（18 - 27）千克。B组平均年龄为57.7±27.2（17 - 159）个月，平均体重为22（19 - 27）千克。两组年龄和体重差异无统计学意义。腹腔镜检查时，共发现147个未闭合的内环直径大于1.5厘米（A组86个，B组61个），经单孔腹腔镜经皮腹膜外闭合术（SPLPEC）后采用SPLMUFRS治疗，A组采用V形固定法，B组采用U形固定法。A组平均手术时间为11.8±1.9（9 - 16）分钟，B组为13.8±2.6（9 - 20）分钟，两组手术时间差异有统计学意义（P<0.001）。所有患者手术均顺利完成。所有患者术后随访1 - 3年，无术后复发病例。部分患者穿刺部位出现短期疼痛或暂时性鞘膜积液，经保守观察后明显好转。虽然两种SPLMUFRS手术方法及手术时间存在差异，但对于内环直径大于1.5厘米的小儿巨大腹股沟疝安全可靠，可降低术后复发率。
