Open versus minilaparoscopic herniorrhaphy for children: a prospective comparative trial with midterm follow-up evaluation
Open versus minilaparoscopic herniorrhaphy for children: a prospective comparative trial with midterm follow-up evaluation
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DOI：
10.1007/s00464-009-0645-6
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发表时间：
2010-01-01
影响因子：
3.1
通讯作者：
Yang, Stephen Shei-Dei
中科院分区：
文献类型：
--
作者：
Tsai, Yao Chou;Wu, Chao-Chuan;Yang, Stephen Shei-Dei
背景 一项前瞻性临床试验旨在比较开放式 (OR) 和微型腹腔镜 (MR) 疝修补术治疗小儿腹股沟疝气的中期手术和功能结果。 方法 2005 年 5 月至 2008 年 5 月期间，前瞻性入组 174 名腹股沟疝儿童进行开放式或微型腹腔镜疝修补术。在这些儿童中，65 名接受了开放式疝修补术，109 名接受了微型腹腔镜疝修补术。门诊就诊时记录术后功能状态、疼痛、并发症和总体满意度进行分析。结果在研究期间，有35名患者因失访而被排除。平均随访期约为2年，两组之间的基线特征匹配。 MR组患者的复发率、术后疼痛、并发症和功能恢复与OR组相当。 MR 患者中没有人出现对侧异时性腹股沟疝，而 OR 患者中这一比例为 9.7% (p = 0.02)。 MR患者的总体满意度高于OR患者（p = 0.03）。结论 微型腹腔镜疝修补术在预防对侧疝发生和总体满意度方面优于开放修补术。
Background A prospective clinical trial was designed to compare the midterm surgical and functional results between open (OR) and minilaparoscopic (MR) herniorrhaphy repairs for pediatric inguinal hernia.Methods Between May 2005 and May 2008, 174 children with inguinal hernias were prospectively enrolled for either open or minilaparoscopic hernia repair. Of these children, 65 underwent open herniorrhaphy and 109 underwent minilaparoscopic herniorrhaphy. The postoperative functional status, pain, complications, and overall satisfaction were documented at outpatient clinic visits for analysis.Results During the study period, 35 patients were lost to follow-up evaluation and thus excluded. The mean follow-up period was about 2 years, and the baseline characteristics were matched between the two groups. The patients in the MR group had recurrence rates, postoperative pain, complications, and functional recovery comparable with those in the OR group. None in the MR patients experienced a contralateral metachronous inguinal hernia compared with 9.7% of the OR patients (p = 0.02). The MR patients had a higher rate of overall satisfaction than the OR patients (p = 0.03).Conclusions Minilaparoscopic herniorrhaphy was superior to open repair with regard to prevention of contralateral hernia occurrence and overall satisfaction.