Abstract:Objective: To study the clinical effect of hernia crochet assisted laparoscopic single site transumbilical treatment of inguinal incarcerated oblique hernia in children. Methods: A retrospective analysis was performed on 100 children with inguinal incarcerated oblique hernia admitted from January 2021 to January 2023. The subjects were divided into study group (50 cases) and control group (50 cases) according to the surgical methods. The study group received hernia crocheted assisted laparoscopic single site transumbilical treatment, while the control group received open surgery. The levels of inflammatory factors [interleukin-6 (IL-6), C-reactive protein (CRP)] before and after surgery were compared with intraoperative indicators (incision length, intraoperative blood loss, and operation time), postoperative indicators (first ventilation time, first time of getting out of bed, and length of hospital stay) and the incidence of complications (scrotal redness, chronic pain, and incision infection) between the two groups. Results: There were no significant differences in IL-6 and CRP levels between the two groups before surgery (P>0.05). Postoperative IL-6 (32.91±6.06) mg/L and CRP (14.53±2.91) ng/L in the study group were significantly lower than those in the control group (42.58±7.84) mg/L and 18.14±3.08 ng/L, and the difference was statistically significant(P<0.05). Incision length (0.39±0.14) cm and intraoperative blood loss (3.41±0.78) ml in the study group were significantly lower than those in the control group (3.37±1.13) cm and (19.42±3.96) ml. The time of operation (32.41±6.73) min, the time of primary ventilation (8.87±1.77) h, the time of first getting out of bed (13.58±2.93) h and the time of hospitalization (2.81±0.69) d were significantly shorter than those of the control group (56.66±10.14) min and the time of primary ventilation (17.18±3). 56) h, the first time out of bed (22.53±3.15)h, the length of hospital stay (4.97±1.85)d, the difference was statistically significant (P<0.05). The incidence of scrotal swelling, chronic pain and incision infection in the study group was significantly lower than that in the control group, the difference was statistically significant (P<0.05). Conclusion: Hernia crochet assisted laparoscopic single site transumbilical treatment of inguinal incarcerated oblique hernia in children with significant clinical efficacy, can reduce inflammatory response in children, can also shorten the length of incision and operation, primary ventilation, initial ambulation, and hospital stay in children, reduce intraoperative blood loss and complications.
朴倩, 孙诗琦. 疝气钩针协助下腹腔镜经脐单部位治疗腹股沟嵌顿性斜疝患儿的临床疗效[J]. 河北医学, 2023, 29(10): 1640-1644.
PIAO Qian, SUN Shiqi. Clinical Efficacy of Hernia Crochet Assisted Laparoscopic Single Site Transumbilical Treatment for Children with Inguinal Incarcerated Oblique Hernia. HeBei Med, 2023, 29(10): 1640-1644.
[1] Yi J,YueBin Z,Ken C,et al.Single-incision laparoscopic surgery for the treatment of incarcerated indirect inguinal hernia in children.[J].Asian journal of surgery,2022,14(25):365-371. [2] Morini F,Dreuning K M A,Janssen L M J H,et al.Surgical management of pediatric inguinal hernia:a systematic review and guideline from the european pediatric surgeons' association evidence and guideline committee.[J].European journal of pediatric surgery,2021,2(10):362-367. [3] 宋晋,赵路红.腹腔镜手术治疗小儿嵌顿性腹股沟斜疝疗效观察[J].长治医学院学报,2020,34(5):347-350. [4] 童松贵,杨洁.腹股沟嵌顿斜疝发生的危险因素及不同手术方式的治疗效果[J].中华疝和腹壁外科杂志(电子版),2020,14(4):424-427. [5] 蔡东汉,李立帜,徐迪.改良腹腔镜与传统法治疗小儿嵌顿性腹股沟斜疝对比分析[J].创伤与急诊电子杂志,2020,8(3):123-126. [6] 刘腾,刘希杰,程风春,等.腹腔镜辅助与传统开放手术治疗小儿嵌顿性腹股沟斜疝的临床疗效[J].滨州医学院学报,2019,42(6):455-458. [7] 马同胜,刘丰丽,曾战东,等.腹腔镜与传统手术治疗新生儿嵌顿性腹股沟斜疝的比较[J].中国微创外科杂志,2018,18(2):124-126. [8] 肖雅,罗雪松,喻正波.腹腔镜手术治疗小儿嵌顿性腹股沟斜疝的临床疗效及安全性研究[J].齐齐哈尔医学院学报,2018,39(1):46-48. [9] 曾战东,刘丰丽,马同胜,等.腹腔镜治疗新生儿嵌顿性腹股沟斜疝的临床研究[J].中国现代手术学杂志,2022,26(1):15-19. [10] Yi J,YueBin Z,Ken C,et al.Single-incision laparoscopic surgery for the treatment of incarcerated indirect inguinal hernia in children[J].Asian Surg,2022,45(7):1489-1490. [11] 宋代强,苏宝利,於林军,等.疝气钩针协助下腹腔镜经脐单部位治疗儿童腹股沟嵌顿性斜疝的效果[J].中国妇幼保健,2022,37(7):1244-1247.