소아 복강경 탈장 수술에서 기존의 고위결찰술에 탈장구멍인대봉합 추가를 통한 재발 위험도의 감소에 관한 연구
등록일 | 2020-01-21 조회수 | 2238


소아 복강경 탈장수술에서 기존의 고위결찰술에 탈장구멍인대봉합 추가를 통한 재발 위험도의 감소에 관한 연구

Adding iliopubic tract repair to high ligation reduces recurrence risk in pediatric 

laparoscopic transabdominal inguinal hernia repair



[Abstract]

Background 

Many laparoscopic methods are available for treating pediatric inguinal hernias.Recurrence after laparoscopic pediatric inguinal hernia repair (LPIHR) is one of the greatestconcerns for surgeons. The present study was performed to evaluate the effects of iliopubictract repair in LPIHR with respect to the recurrence rate, surgical outcomes, andcomplications.Methods: LPIHR was performed in 3386 pediatric patients aged <10 years from January2016 to June 2018. The patients were categorized into two groups according to the operativetechniques: high ligation alone (1736 patients) and additional iliopubic tract repair (1650patients). In high ligation surgery, the hernia sac was removed and the peritoneum was closed.In iliopubic tract repair surgery, iliopubic tract and transversalis fascia arch sutures wereadded. 

 

[Results]

Recurrence only occurred in the high ligation group; no patients in the iliopubic tractrepair group developed recurrence [0.35% (6/1736) vs. 0.00% (0/1650), respectively; p =0.014]. Other surgical outcomes and complications did not differ between the two groups. Sixpatients in the high ligation group developed recurrence: four infants aged <1 year and twochildren aged >1 year. The mean duration from the first operation to reoperation in these sixpatients was 11.8 months; five patients developed recurrence within 1 year after the initialoperation. All patients had a recurrent indirect hernia, and the location of the hernial defectswas on the medial side of the previous stitch. The logistic regression indicated that thedifference between the two groups affected the recurrence rate. This finding predicted thatiliopubic tract repair is associated with a lower recurrence rate than high ligation.

 

[Conclusions]

This study of transabdominal LPIHR indicates that iliopubic tract repair resultsin a small but significant decrease in the risk of recurrence.

 

[Keywords]

laparoscopic pediatric inguinal hernia repair, iliopubic tract repair, recurrence

 

 

다음글 | 불룩한 중증 겨드랑이 부유방 환자를 위한 두 단계 수술의 효과: 첫 번째 단계 수술에서 유선의 제거 후 두 번째 단계 수술에서 불필요한 피부의 절제
이전글 | 2018 대한외과학회 (ACKSS) 하지정맥류수술 연구결과 발표
      

카카오톡 QR코드 X
 

 

 

 

업체명 : 담소유병원   |   대표자 : 이성렬   |   사업자등록증 : 211-10-27573

서울시 강남구 학동로 234 담소유빌딩(구번지 논현동 210)   |   TEL : 02-542-2222   |   FAX : 02-542-0099

광고제안문의 E-mail : suggest@damsoyugr.com

개인정보처리방침  직원전용게시판