腹腔镜下疝囊高位结扎治疗小儿腹股沟疝术后复发的相关因素

Risk factors for recurrence after laparoscopic high ligation of hernia sac for pediatric inguinal hernia

目的:探讨腹腔镜下疝囊高位结扎术治疗小儿腹股沟疝的术后复发情况与相关危险因素。方法:选取2013年1月至2016年7月河南科技大学第一附属医院收治的246例腹股沟疝患儿,分析术后复发情况与相关危险因素。结果:术后9例患者复发,发生率为3.66%,再次行手术后均治愈。单因素分析结果显示:术后复发与年龄、合并肥胖症、内环口大小、结扎线及术者经验相关(P<0.05),而与性别、合并呼吸系统疾病、合并隐匿疝、疝囊部位、病程及术前有无嵌顿无相关性(P>0.05)。多因素分析结果显示:年龄≥6岁、内环口≥3 cm、可吸收缝线及术者经验缺乏是术后复发的独立危险因素(P<0.05)。结论:腹腔镜下疝囊高位结扎治疗小儿腹股沟疝术后仍存在一定的复发率,尤其是具备年龄≥6岁、内环口≥3 cm、使用可吸收缝线及术者经验缺乏等独立危险因素的患儿。

Objective： To explore the recurrence rate and its risk factors after laparoscopic high ligation of hernia sac for pediatric inguinal hernia. Methods： A total of 246 patients with pediatric inguinal hernia from January 2013 to July 2016 were enrolled. The recurrence rate and its risk factors were analyzed. Results： Nine cases recurred and the rate was 3.66%. All of them were cured by underwent reoperation. Univariate analysis identified the following risk factors as age, obesity, size of internal inguinal ring, suturing type and surgical experience （P〈0.05）. But gender, respiratory disease, concealed hernia, location of hernial sac, course of disease and incarcerated hernia did not have a significant effect on postoperative recurrence （P〉0.05）. Logistic regression analysis revealed that age ≥6 years old, size of internal inguinal ring ≥3 cm, absorbable suture and lack of surgical experience were independent risk factors for major complications （P〈0.05）. Conclusion： Recurrence after laparoscopic high ligation of hernia sac of pediatric inguinal hernia has a certain incidence. Patients with age ≥6 years old, size of internal inguinal ring ≥3 cm, absorbable suture and lack experience of operators tend to recur.