Laparoscopic inguinal hernia repair in premature neonates: is it safe?
Laparoscopic inguinal hernia repair in premature neonates: is it safe?
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DOI：
10.1007/s00383-012-3240-1
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发表时间：
2013-04-01
影响因子：
1.8
通讯作者：
Tam, P. K. H.
中科院分区：
文献类型：
--
作者：
Chan, I. H. Y.;Lau, C. T.;Tam, P. K. H.
随着临床医学的进步，现在许多早产儿都有很好的生存结果。由于该组腹股沟疝发生率高，且文献中关于最佳修复时间的数据较少，本研究旨在回顾我们在早产儿腹腔镜修复中的经验。本中心住院期间发现腹股沟疝的早产儿，除有腹腔镜手术禁忌外，均在体重达到2.5 kg时行腹腔镜修补。回顾性分析2001年至2011年所有行腹腔镜腹股沟疝修补术的早产儿。记录手术结果、并发症、嵌顿风险和术后呼吸暂停风险。在此期间，共有79名早产儿接受腹腔镜腹股沟疝修补术。出生时平均胎龄31.9周（27 ~ 36周），手术时平均胎龄46.5周（33 ~ 92周）。1例患者嵌顿，在等待择期修复时需要紧急手术。平均手术时间为44.9 min （25 ~ 93 min）。1例（1.3%）复发。术后无患者出现呼吸暂停。只要有良好的麻醉支持，当早产儿达到合理的体型时，腹腔镜疝修补术是安全可行的。在这项研究中，嵌顿的风险很低，值得等待体重增加，从而促进腹腔镜修复。
With advances in clinical medicine, many premature babies nowadays can have excellent survival outcomes. As the incidence of inguinal hernias in this group is high and there is scarce data in the literature regarding the optimal timing for repair, this study aims to review our experience in laparoscopic repair in premature infants.In our centre, premature neonates with inguinal hernia noted during hospitalization were offered laparoscopic repair when the body weights reached 2.5 kg unless there is contraindication for laparoscopy. A retrospective review was carried out for all premature neonates who underwent laparoscopic inguinal hernia repair from 2001 to 2011. The operative results, complications, incarceration risk and postoperative apnea risk were recorded.A total of 79 premature neonates received laparoscopic inguinal hernia repair during this period. The mean gestational age at birth was 31.9 weeks (27-36 weeks) and the mean gestational age at operation was 46.5 weeks (33-92 weeks). One patient had incarceration and required emergency operation while waiting for the elective repair. The mean operative time was 44.9 min (25-93 min). One patient (1.3 %) had recurrence. No postoperative apnea was noted in any patient.Laparoscopic hernia repair is safe and feasible in premature neonates when they attain reasonable body size, as long as there is excellent anaesthesia support. Low risk of incarceration was noted in this study and it is worth waiting for the body weight to build up and hence facilitate laparoscopic repair.