先天性腹股沟疝[CIH]可以使用文献中记载的各种方法进行腹腔镜治疗。许多作者建议分割囊并缝合腹膜缺损。其他研究声称仅腹膜断开就足够了。在这项研究中,可行性,手术时间,复发率,比较了有或没有腹膜缺损缝合的CIH囊针眼断开的其他术后并发症。一项前瞻性对照随机对照试验于2020年1月至2022年12月进行。纳入了符合研究要求的230名患者。患者被随机分配到A组或B组。一组116例患者(A组)的囊颈部针镜分离和腹膜缺损闭合。其余114例患者(B组)接受了针镜分离,没有腹膜缺损闭合(Sutuless组)。使用针镜断开术修复了230例患者的260例疝缺损,有或没有缝合缺损。有89名女性(38.7%)和141名男性(61.3%),平均年龄5.14±2.79岁。A组,单侧疝的平均手术时间为27.98±2.89,双侧疝的平均手术时间为37.29±4.68,然而,B组,单侧和双侧疝的平均手术时间为20.37±2.37和23.38±2.22,分别。在运行时间方面,无论是单边还是双边,两组之间有显著差异。A组和B组的平均内环直径[IRD]无显著差异,A组为1.21±0.18cm,B组为1.19±0.11cm。术后没有鞘膜积液形成,复发,医源性的睾丸上升,或者睾丸萎缩.所有患者在3个月随访时都有几乎看不见的疤痕,没有瘢痕疙瘩发展。针状分离疝囊而不缝合腹膜缺损是可行的,安全,侵入性较小。它提供了出色的美容效果,手术时间短,无复发。
Congenital inguinal hernia [CIH] can be treated laparoscopically using various methods documented in the literature. Many authors have recommended dividing the sac and stitching peritoneal defects. Other studies claimed that peritoneal disconnection alone is sufficient. In this
study, the feasibility, operative time, recurrence rate, and other postoperative complications of needlescopic disconnection of the CIH sac with or without peritoneal defect suturing were compared. A prospective controlled randomized
trial was conducted between January 2020 and December 2022. Two hundred and thirty patients who met the
study requirements were included. Patients were assigned at random to either Group A or Group B. A group of 116 patients (Group A) had needlescopic
separation of the neck of the sac and peritoneal defect closure. The remaining 114 patients (Group B) underwent needlescopic
separation without peritoneal defect closure (Sutureless group). A total of 260 hernial defects in 230 patients were repaired using needlescopic disconnection with or without suturing of the defect. There were 89 females (38.7%) and 141 males (61.3%), with a mean age of 5.14 ± 2.79 years. In Group A, the mean operation time was 27.98 ± 2.89 for a unilateral hernia and 37.29 ± 4.68 for a bilateral one, whereas, in Group B, the mean operation time was 20.37 ± 2.37 and 23.38 ± 2.22 for a unilateral and bilateral hernia, respectively. In terms of the operating time, whether unilateral or bilateral, there was a significant difference between the groups. There was no significant difference between groups A and B in the mean Internal Ring Diameter [IRD], which was 1.21 ± 0.18 cm in group A and 1.19 ± 0.11 cm in group B. Throughout the follow-up period, there was no postoperative hydrocele formation, recurrence, iatrogenic ascending of the testes, or testicular atrophy. All patients had nearly invisible scars with no keloid development at 3 months follow-up. Needlescopically separating the hernia sac without stitching the peritoneal defect is feasible, safe, and less invasive. It provides outstanding cosmetic results with a short operative time and no recurrence.