探讨完全经脐单孔腹腔镜手术、腹横纹小切口手术对小儿腹股沟疝的疗效及在不同年龄分层患儿中的疗效差异。

本研究为前瞻性随机对照试验，纳入2023年1月至2025年1月，在新疆医科大学第一附属医院行腹股沟疝治疗的患儿120例，采用简单随机数字法将患儿分为对照组（腹横纹小切口手术）和研究组（完全经脐单孔腹腔镜手术），各60例。比较2组患儿的手术相关指标（切口长度、手术时间、术中出血量、术后排气时间、住院时间）以及术后面部表情、腿部活动、活动度、哭闹、可安慰性疼痛行为量表评分、儿童生活质量评分、并发症发生情况。并将患儿分为3~6岁组及7~12组，比较不同年龄组中2组的疗效差异。

研究组患儿的手术相关指标均较对照组改善，差异均有统计学意义（P<0.05），组间整体差异效应量显著，手术相关指标合并Hedges'g=2.44（大效应）。与术前相比，2组患儿术后疼痛程度均降低，生理功能、情感功能评分均升高，且研究组优于对照组，差异均有统计学意义（P<0.05）；术后组间比较各效应量Hedges'g>0.8，均为大效应量。研究组总并发症发生率较对照组更低，差异有统计学意义（OR=0.183，P=0.004）。研究组术中探查发现对侧隐匿性疝8例。在两个年龄分层组中，研究组患儿的手术相关指标、疼痛评分、儿童生活质量评分均优于对照组（P<0.05）。并发症发生率，在7~12岁患儿中，2组差异无统计学意义；在3~6岁患儿中研究组仍低于对照组，差异有统计学意义（P<0.05）。

完全经脐单孔腹腔镜手术与腹横纹小切口手术对小儿腹股沟疝均疗效可靠，但完全经脐单孔腹腔镜手术术中可探查发现对侧隐匿性疝，手术创伤小，患儿术后恢复快，在并发症发生方面低龄患儿可能受益更大。

To compare the clinical efficacy of totally transumbilical single-port laparoscopic surgery and surgery through a small transverse abdominal skin-crease incision in children with inguinal hernia, and to evaluate differences in treatment outcomes between the two surgical approaches across different age groups.

This prospective randomized controlled trial included 120 children with inguinal hernia who underwent surgical treatment at the First Affiliated Hospital of Xinjiang Medical University between January 2023 and January 2025. The children were randomly assigned, using a simple random number method, to either the control group (surgery through a small transverse abdominal skin-crease incision) or the study group (totally transumbilical single-port laparoscopic surgery), with 60 children in each group. Perioperative outcomes, including incision length, operative time, intraoperative blood loss, time to first postoperative flatus, and length of hospital stay, were compared between the two groups. Pain intensity was assessed using the Face, Legs, Activity, Cry, and Consolability (FLACC) scale. Pediatric quality-of-life scores and postoperative complications were also evaluated. In addition, the children were stratified into two age groups (3–6 years and 7–12 years), and treatment outcomes were compared between the two surgical approaches within each age stratum.

All perioperative outcomes were significantly more favorable in the study group than in the control group (all P<0.05). The pooled effect size for the perioperative outcomes indicated a large between-group difference (Hedges' g=2.44). Compared with preoperative values, postoperative pain scores decreased, while physical and emotional functioning scores increased in both groups. These improvements were significantly greater in the study group than in the control group (all P<0.05). All postoperative between-group effect sizes were large (Hedges' g>0.8). The overall incidence of postoperative complications was significantly lower in the study group than in the control group [odds ratio (OR)=0.183, P=0.004]. Intraoperative exploration identified occult contralateral inguinal hernias in eight children in the study group. In both age strata, the study group demonstrated significantly more favorable perioperative outcomes, lower pain scores, and higher pediatric quality-of-life scores than the control group (all P<0.05). Among children aged 7–12 years, the difference in complication rates between the two groups was not statistically significant. However, among children aged 3–6 years, the complication rate remained significantly lower in the study group than in the control group (P<0.05).

Both totally transumbilical single-port laparoscopic surgery and surgery through a small transverse abdominal skin-crease incision achieve reliable efficacy for pediatric inguinal hernia. The laparoscopic approach allows intraoperative detection of occult contralateral inguinal hernias, causes less surgical trauma, and facilitates faster postoperative recovery. Younger children may derive greater benefits from this approach in terms of reducing postoperative complications.