Long-Term Outcomes of Laparoscopic Intracorporeal Inguinal Hernia Ligation in Infants Under 1 Year of Age
Long-Term Outcomes of Laparoscopic Intracorporeal Inguinal Hernia Ligation in Infants Under 1 Year of Age
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DOI：
10.1089/lap.2012.0183
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发表时间：
2013-04-01
影响因子：
1.3
通讯作者：
Tsang, Thomas
中科院分区：
文献类型：
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作者：
Cho, Alexander;Devany, Adam;Tsang, Thomas
背景：目前大多数关于腹腔镜腹股沟疝修补术的文献都是将所有的儿科患者集中在一起。本研究旨在评估1岁以下儿童接受腹股沟环扎术的远期疗效，以确定在这一特殊人群中是否存在潜在的优势或局限性。患者和方法：由一名儿科医生对1岁以下儿童进行腹股沟疝环扎术。数据来源于病例记录、医院电子病历和家长电话咨询。结果：自2003年11月至2010年10月，114例1岁以下的患儿接受了腹腔镜腹股沟疝修补术。男：女4：1，平均矫正年龄15.5(3~42)周，平均体重5.3(1.9~9.8)kg。所有患者的病历和电子记录都被调阅了。42%的父母是可联系的(平均手术后4年)。一名男孩在3年后出现一次无症状侧复发。5例患者在腹腔镜下腹股沟疝修补术后进行了固定术，尽管3例患者在手术时已知未下降。1例腹股沟复发率可能低于1岁以下接受传统开放修补术的患者。然而，在这组腹腔镜组中，医源性隐睾症的发生率可能更高。
Background: The majority of current literature regarding laparoscopic inguinal hernia repair group all their pediatric patients together. This study aimed to evaluate the long-term outcomes of patients who underwent laparoscopic intracorporeal inguinal hernia ligation under the age of 1 year to ascertain if there were hidden advantages or limitations in this particular group.Patients and Methods: Patients under the age of 1 year at time of laparoscopic intracorporeal inguinal hernia ligation by a single pediatric surgeon were identified. Data were obtained from case notes, hospital electronic records, and parental telephone consultation.Results: One hundred fourteen patients under the age of 1 year underwent laparoscopic inguinal hernia repair from November 2003 to October 2010. The male: female ratio was 4:1. The mean corrected age at surgery was 15.5 (range, 3-42) weeks, and the mean weight at surgery was 5.3 (range, 1.9-9.8) kg. All patients' case notes and electronic records were accessed. Forty-two percent of parents were contactable (mean of 4 years following surgery). There was one recurrence on the asymptomatic side in a boy that presented 3 years later. Five patients required orchidopexy following laparoscopic hernia repair, although 3 cases were known to be undescended at the time of surgery. One patient had intermittent ipsilateral groin swelling that resolved spontaneously after 6 months.Conclusions: Laparoscopic intracorporeal inguinal hernia ligation in patients under the age of 1 year is safe and effective. Recurrence rates may be lower than those in patients under 1 year of age undergoing a traditional open repair. However, there may be a higher rate iatrogenic of cryptorchidism in this laparoscopic group.