疝气针协助单孔腹腔镜术在腹股沟斜疝患儿中的应用及术后复发分析

Application and Postoperative Recurrence Analysis of Hernia Needle Assisted Single Hole Laparoscopic Surgery in Children with Indirect Inguinal Hernia

目的探讨疝气针协助单孔腹腔镜术在腹股沟斜疝患儿中的应用,并分析术后复发的影响因素。方法选取2020年1月-2022年12月在濮阳市人民医院诊治的腹股沟斜疝患儿200例,随机分为对照组和研究组,每组各100例,对照组给予传统手术治疗,研究组给予疝气针协助单孔腹腔镜术治疗,比较两组围术期相关指标、并发症发生情况,并分析术后复发的危险因素。结果研究组手术时间、自主活动时间、住院时间明显短于对照组(P<0.05);研究组术中出血量、切口长度明显低于对照组(P<0.05);研究组并发症发生率低于对照组(χ^(2)=16.611,P<0.05)。术后13例复发,经单因素分析,内环口直径、发病部位、巨大疝、疝环粘连程度、环扎或缝扎、哭闹多是术后复发的影响因素(P<0.05);经二元Logistic回归分析,内环口直径≥2 cm、巨大疝、疝环粘连程度中度、疝环粘连程度重度、环扎或缝扎是术后复发的危险因素(P<0.05)。结论疝气针协助单孔腹腔镜术治疗腹股沟斜疝患儿,可有效缩短手术时间,缩小手术切口,减少术中出血量,降低并发症,促进患儿更快恢复;腹股沟斜疝患儿术后复发与内环口直径≥2 cm、巨大疝、疝环粘连程度中度、疝环粘连程度重度、环扎或缝扎有关。

Objective To explore the application of hernia needle assisted single hole laparoscopic surgery in children with indirect inguinal hernia,and analyze the influencing factors of postoperative recurrence.Methods 200 children with inguinal hernia who were diagnosed and treated in our hospital from January 2020 to December 2022 were randomly divided into two groups:a control group of 100 cases and a study group of 100 cases.The control group received traditional surgical treatment,while the study group received hernia needle assisted single hole laparoscopic surgery.The perioperative related indicators and complications of the two groups were compared,and the risk factors for postoperative recurrence were analyzed.Result The surgical time,autonomous activity time,and hospitalization time of the study group were significantly shorter than those of the control group(P<0.05),while the intraoperative bleeding volume and incision length of the study group were significantly lower than those of the control group(P<0.05).The incidence of complications in the study group was 4.00%,which was significantly lower than the 24.00%in the control group(P<0.05).13 cases experienced postoperative recurrence,and through univariate analysis,the diameter of the internal ring,the site of the disease,the degree of huge hernia,the degree of hernia ring adhesion,cerclage or suturing,and crying were mostly influencing factors for postoperative recurrence(P<0.05).Through binary logistic regression analysis,the risk factors for postoperative recurrence were internal ring diameter≥2 cm,huge hernia,moderate degree of hernia ring adhesion,severe degree of hernia ring adhesion,and cerclage or suturing(P<0.05).Conclusion Hernia needle assisted single hole laparoscopic surgery for indirect inguinal hernia in children can effectively shorten the operation time,narrow the Surgical incision,reduce intraoperative bleeding,reduce complications,and promote faster recovery of children.Postoperative recurrence of indirect inguinal hernia in children is related to internal ring diameter≥2 cm,huge hernia,moderate degree of hernia ring adhesion,severe degree of hernia ring adhesion,and cerclage or suture.