Yu Zhongjing,Lin Zhenying,Li Huanyuan,et al.Clinical efficacies of 1.1 mm endoscopic technique for hydrocele and inguinal hernia in children[J].Journal of Clinical Pediatric Surgery,,():584-588.[doi:10.3760/cma.j.cn101785-202401014-014]
Clinical efficacies of 1.1 mm endoscopic technique for hydrocele and inguinal hernia in children
- Keywords:
- Testicular Hydrocele; Hernia; Inguinal; Laparoscopy; Treatment Outcome; Comparative Study; Child
- Abstract:
- Objective To explore the efficacy,advantages and disadvantages of treating pediatric hydrocele/inguinal hernia with a 1.1 mm diameter transumbilical single-port laparoscopy.Methods A retrospective analysis was conducted for the clinical data and follow-up findings of 30 children with hydrocele/inguinal hernia from January 2022 to August 2023.A STORZ 1.1 mm laparoscope was applied with a homemade Trocar.Based upon the size of incision and the number of puncture holes,they were assigned into three groups of A (a single 1.8 mm umbilical incision,n=30),B (a single 3.3 mm umbilical incision,n=30) and C (double 3.3 mm umbilical incisions,n=80).The differences in gender,onset time,age,disease type,lesion site and operative duration (unilateral/bilateral) were compared among three groups.Results In group A,the average operative age was 2.57 years with an average follow-up duration of 5.22 months.In group B,the average age was 3.81 years with an average follow-up duration of 6.70 months.In Group C,the average age was 2.81 years with an average follow-up duration of 6.38 months.None of them exhibited such postoperative complications as recurrence,iatrogenic cryptorchidism,incision infection or scrotal edema.However,one case (1/80) in group C developed postoperative granuloma at inguinal incision site.No statistically significant difference existed among three groups in terms of gender,type of disease,differences in unilateral/bilateral conditions before and during surgery,operative duration or duration of illness.However,the difference in average age and unilateral operative duration was statistically significant among three groups (P=0.030 and P=0.039).Average age of group A/C was lower than that in group B (P=0.012 and P=0.024).Unilateral operative duration was longer in group A/C than that in group B (P=0.045 and P=0.015).Conclusions As compared to 3 mm single-umbilical-port laparoscopy and 3 mm dual-umbilical-port laparoscopy,1.1 mm single-umbilical-port laparoscopy for pediatric hydrocele/inguinal hernia has demonstrated consistent surgical outcomes with no increase in postoperative complications.It is a safe and reliable surgery with mini-invasive scars.However,due to a limited number of cases,further experiences and equipment upgrades are required.
References:
[1] 蔡威,孙宁,魏光辉.小儿外科学[M].第5版.北京:人民卫生出版社,2014. Cai W,Sun N,Wei GH.Pediatric Surgery[M].Edition V.Beijing:People’s Medical Publishing House,2014.
[2] Panabokke G,Clifford ID,Craig SS,et al.Reduction of paediatric inguinal hernias[J].Emerg Med Australas,2016,28(2):224-227.DOI:10.1111/1742-6723.12549.
[3] Yeap E,Pacilli M,Nataraja RM.Inguinal hernias in children[J].Aust J Gen Pract,2020,49(1/2):38-43.DOI:10.31128/AJGP-08-19-5037.
[4] O’Brien L,Hannan E,Hassett S.Laparoscopic paediatric inguinal hernia repair:lessons learned from 102 cases[J].Ir J Med Sci,2023,192(1):321-326.DOI:10.1007/s11845-022-02975-2.
[5] Esposito C,Montinaro L,Alicchio F,et al.Technical standardization of laparoscopic herniorraphy in pediatric patients[J].World J Surg,2009,33(9):1846-1850.DOI:10.1007/s00268-009-0121-4.
[6] Zhang L,Zhang R,Zhang JF,et al.To use a simple hernia needle for single-port laparoscopic percutaneous inguinal hernia repair in children:a 5-year experience study[J].Front Pediatr,2024,11:1298643.DOI:10.3389/fped.2023.1298643.
[7] 谷奇,李龙,叶辉,等.经脐单孔腹腔镜内环口结扎术治疗小儿腹股沟疝及鞘膜积液的探讨[J].临床小儿外科杂志,2013,12(3):194-195.DOI:10.3969/j.issn.1671-6353.2013.03.009. Gu Q,Li L,Ye H,et al.Single-port laparoscopic techniques for inguinal hernia and hydrocele in children[J].DOI:10.3969/j.issn.1671-6353.2013.03.009.
[8] 张丰年,李炳,陈卫兵,等.经脐单部位腹腔镜下应用注射器行疝囊高位结扎术42例[J].临床小儿外科杂志,2018,17(1):51-53.DOI:10.3969/j.issn.1671-6353.2018.01.013. Zhang FN,Li B,Chen WB,et al.High-ligation of hernia sac with syringe under transumbilical single-site laparoscopy for inguinal hernia:a report of 42 cases[J].J Clin Ped Sur,2018,17(1):51-53.DOI:10.3969/j.issn.1671-6353.2018.01.013.
[9] Zhang HX,Feng Y,Wang JG,et al.Comparison of laparoscopic percutaneous extraperitoneal internal ring closure by two-hook hernia needle and open repair for pediatric inguinal hernia[J].J Laparoendosc Adv Surg Tech A,2023,33(8):821-828.DOI:10.1089/lap.2022.0529.
[10] Nakashima M,Ide K,Kawakami K.Laparoscopic versus open repair for inguinal hernia in children:a retrospective cohort study[J].Surg Today,2019,49(12):1044-1050.DOI:10.1007/s00595-019-01847-0.
[11] Elhaddad A,Awad M,Shehata SM,et al.Laparoscopic management of infantile hydrocele in pediatric age group[J].Pediatr Surg Int,2022,38(4):581-587.DOI:10.1007/s00383-022-05064-8.
[12] 蔡志明,吴文华,罗健,等.针式腹腔镜治疗小儿腹股沟斜疝的临床应用[J].中华小儿外科杂志,2000,21(2):101-102.DOI:10.3760/cma.j.issn.0253-3006.2000.02.013. Cai ZM,Wu WH,Luo J,et al.Clinical application of needle-type laparoscopic herniotomy for inguinal hernia in children[J].Chin J Pediatr Surg,2000,21(2):101-102.DOI:10.3760/cma.j.issn.0253-3006.2000.02.013.
[13] Turial S,Saied A,Schier F.Microlaparoscopic hernia repair in children:initial experiences[J].Surg Innov,2011,18(4):368-372.DOI:10.1177/1553350611406742.
Memo
收稿日期:2024-01-05。
通信作者:张宝欣,Email:1305832155@qq.com