Analysis of risk factors of recurrence after laparoscopic high ligation of hernia sac in children with indirect hernia

doi:10.3877/cma.j.issn.1674-392X.2019.05.013

Abstract

Abstract:

Objective

To analyze the recurrence risk factors after laparoscopic high ligation of hernia sac in children with indirect hernia.

Methods

From December 2016 to December 2018, 180 children underwent laparoscopic high ligation of hernia sac in Sichuan Provincial People's Hospital were selected. Univariate and multivariate analysis of recurrence factors such as gender, age, body mass index, disease duration, location of sac, size of internal inguinal ring and other factors were evaluated by Logistic regression model.

Results

There were 8 children with recurrence of hernias between 3 to 12 months after operation and the recurrence rate was 4.44%, and the age of children with recurrence were over 5 years old; the results showed that age, suturing type and size of internal inguinal ring were independent risk factors of recurrence after operation (all P<0.05).

Conclusion

Laparoscopic high ligation of hernial sac for indirect hernia in children should not choose absorbable suture to reduce the risk of postoperative recurrence.

Key words: Indirect hernia, Laparoscopes, High ligation of hernial sac, Recurrence

Yulian Yang, Jiaxu Zhang, Yan Tan, Yanqun Xiong. Analysis of risk factors of recurrence after laparoscopic high ligation of hernia sac in children with indirect hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(05): 437-439.

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URL: https://zhshfbwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-392X.2019.05.013

https://zhshfbwkzz.cma-cmc.com.cn/EN/Y2019/V13/I05/437

Figures/Tables 2

References 15

[1]	Feng S, Zhao L, Liao Z, et a1. Open versus 1aparoscopic inguinal herniotomy in children: a systematic review and metaanalysis focusing on postoperative complications[J]. Surg Laparosc Endosc Percutan Tech, 2015, 25(4): 275-280.
[2]	张辉敏，李萍，陈善昌. 常规切口、小切口与腹腔镜下疝囊高位结扎治疗小儿腹股沟斜疝[J]. 中国临床研究, 2012, 25(8): 775-776.
[3]	Xiang B, Jin S, Zhong L, et al. Reason for recurrence after the laparoseopic repair of indirect inguinal hernia in children[J]. J Laparoendosc Adv Surg Tech A, 2015, 25(8): 681-683.
[4]	孟繁杰，王海刚，李燕书, 等. 单孔腹腔镜疝囊高位结扎术在儿童腹股沟斜疝中的应用[J/CD]. 中华疝和腹壁外科杂志(电子版), 2013, 7(1): 38-40.
[5]	Esposito C, St Peter SD, Escolino M, et a1. Laparoscopic versus open inguinal hernia repair in pediatric patients: a systematic review[J]. J Laparoendosc Adv Surg Tech A, 2014, 24(11): 811-818.
[6]	陈栋. 下腹小横切口治疗165例小儿腹股沟斜疝体会[J]. 中国妇幼保健, 2010, 25(20): 2899-2900.
[7]	Miyake H, Fukumoto K, Yamoto M, et a1. Comparsion of percutaneous extraperitoneal closure(LPEC) and open repair for pediatric inguinal hernia: experience of a single institution with over 1000 cases[J]. Surg Endosc, 2016, 30(4): 1466-1472.
[8]	Li S, Tang ST, Aubdoollah TH, et a1. A modified approach for inguinal hernias in children: hybrid single-incision laparoscopic intraperitoneal ligation[J]. J Laparoendose Adv Surg Tech A, 2015, 25(8): 689-693.
[9]	李晓伟，俞刚. 腹腔镜下小儿斜疝手术治疗128例体会[J]. 中国妇幼保健, 2009, 24(24): 3454-3455.
[10]	Eb-Dhuwaib Y, Corless D, Emmett C, et a1. Laparoscopic versus open repair of inguinal hernia: a longitudinal cohort study[J]. Surg Endosc, 2013, 27(3): 936-945.
[11]	健童，梁健升，吴志强, 等. 四种手术方法治疗巨大小儿疝的临床对比分析(附412例报告)[J/CD]. 中华疝和腹壁外科杂志(电子版), 2012, 6(3): 875-878.
[12]	向东洲，卢宗耀，王康太, 等. 经脐单手单孔腹腔镜治疗小儿腹股沟斜疝145例体会[J]. 中国普外基础与临床杂志, 2016, 23(5): 601-603.
[13]	Grimsby GM, Keays MA, VRlanueva C, et a1. Nonabsorbable sutures are associated with lower recurrence rates in laparoscopic percutaneous inguinal hernia ligation[J]. J Pediatr Urol, 2015, 11(5): 275.
[14]	周凯，杨向东，付晓君, 等. 小儿腹腔镜疝囊高位结扎术与传统疝囊高位结扎术的临床研究[J]. 中华全科医学, 2015, 13(5): 719-722.
[15]	Blatnik JA, Harth KC, Krpata DM, et al. Stitch versus searevaluationof laparoscopic pediatric inguinal hernia repair: a pilot study in a rabbit model[J]. J Laparoendose Adv Surg Tech A, 2012, 22(8): 848-851.

影响因素		例数	OR	95% CI	P值
性别比(男∶女)		144∶36	1.89	0.69~5.93	0.32
年龄		?	?	?	?
?	≤3岁	136	4.96	2.51~10.68	0.02
?	4~6岁	34	?	?	?
?	>6岁	10	?	?	?
病程		90	1.48	0.73~2.56	0.21
体质量指数		90	0.98	0.45~1.25	0.42
术前有无嵌顿(有∶无)		22∶158	0.27	0.03~2.69	0.24
疝囊部位		?	?	?	?
?	左侧	32	0.72	0.43~1.09	0.09
?	右侧	134	?	?	?
?	双侧	14	?	?	?
内环口大小		?	?	?	?
?	<1 cm	124	3.62	1.82~7.35	0.02
?	1~2 cm	44	?	?	?
?	>2 cm	12	?	?	?
结扎线类型		?	?	?	?
?	可吸收线	30	4.98	1.53~12.94	0.01
?	不可吸收线	150	?	?	?

影响因素		例数	OR	95% CI	P值
性别比(男∶女)		144∶36	1.89	0.69~5.93	0.32
年龄		?	?	?	?
?	≤3岁	136	4.96	2.51~10.68	0.02
?	4~6岁	34	?	?	?
?	>6岁	10	?	?	?
病程		90	1.48	0.73~2.56	0.21
体质量指数		90	0.98	0.45~1.25	0.42
术前有无嵌顿(有∶无)		22∶158	0.27	0.03~2.69	0.24
疝囊部位		?	?	?	?
?	左侧	32	0.72	0.43~1.09	0.09
?	右侧	134	?	?	?
?	双侧	14	?	?	?
内环口大小		?	?	?	?
?	<1 cm	124	3.62	1.82~7.35	0.02
?	1~2 cm	44	?	?	?
?	>2 cm	12	?	?	?
结扎线类型		?	?	?	?
?	可吸收线	30	4.98	1.53~12.94	0.01
?	不可吸收线	150	?	?	?

影响因素	β	S.E	Wald	OR	95% CI	P值
年龄	1.45	0.32	20.53	7.04	2.32~13.05	0.01
结扎线类型	1.53	0.44	12.09	6.03	1.74~14.46	0.02
内环口直径	1.96	0.73	7.23	8.32	1.53~37.46	0.01

影响因素	β	S.E	Wald	OR	95% CI	P值
年龄	1.45	0.32	20.53	7.04	2.32~13.05	0.01
结扎线类型	1.53	0.44	12.09	6.03	1.74~14.46	0.02
内环口直径	1.96	0.73	7.23	8.32	1.53~37.46	0.01

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