青少年腹股沟疝术后复发的危险因素及对策

Risk factors and countermeasures for recurrence of adolescent inguinal hernia after operation

青少年腹股沟疝的发病率和复发率均低于成人平均水平,传统的疝囊高位结扎术和内环缩窄术治疗青少年腹股沟疝效果令人满意。为进一步降低术后复发率,很多医院治疗青少年腹股沟疝时引入补片疝修补技术,但目前尚无证据证明这种改变是有益或必须的。腹腔镜经皮疝囊高位结扎术是治疗青少年腹股沟疝的重要术式,然而其与开放手术行疝囊结扎不同,应用可吸收线结扎可能会成为疝复发的高危因素。对于有经验的医生,青少年腹股沟疝手术并发症中,复发并不是一个严重问题,针对复发采取的措施必须综合考虑,且还需要进一步的临床研究提供证据支持。

The incidence and recurrence rate of adolescent inguinal hernia are lower than the average level of adults.The high ligation of hernia sac and Marcy procedure are satisfactory for them.To further reduce postoperative recurrence,many hospitals have introduced mesh technique for the treatment of inguinal hernia in adolescents,but there is no evidence that the change is beneficial or necessary.Laparoscopic technique is used for the treatment of inguinal hernia in adolescents.An important surgical method is percutaneous high ligation of hernia sac.Different from the traditional procedure of hernia sac ligation,using absorbable suture may be a high risk factor for hernia recurrence.For experienced surgeon,the complication of recurrence is not a serious problem in inguinal hernia surgery in adolescents.Measures taken for recurrence must be considered comprehensively,and further clinical trials are needed to provide evidence support.