不同小儿年龄组腹腔镜腹股沟疝修补术技术分析:EUPSA欧洲小儿外科学员调查。

IF 1.5 3区 医学 Q2 PEDIATRICS European Journal of Pediatric Surgery Pub Date : 2024-08-08 DOI:10.1055/s-0044-1788928
Hilmican Ulman, Ophelia Aubert, Agnieszka Wiernik, Julio César Moreno-Alfonso, Marta Gazzaneo, Alexander Sterlin, Amulya K Saxena
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引用次数: 0

摘要

目的:本调查分析了不同年龄段小儿腹腔镜腹股沟疝修补术(LIHR)的技术:由欧洲小儿外科医生协会(EUPSA)欧洲小儿外科受训者(TEPS)腹腔镜腹股沟疝修补术工作组(LIHR Working Group)对小儿外科医生进行在线调查,收集了 38 个问题的数据:来自 22 个国家的 183 名外科医生完成了调查。77%的受访者至少进行过一次LIHR手术。关于对患者性别的偏好,7%的受访者仅对特定女性实施过LIHR,9%的受访者对女性实施过常规LIHR,15%的受访者对有年龄/体重限制的男女均实施过LIHR,24%的受访者对男女均实施过常规LIHR,31%的受访者对特定病例实施过LIHR,14%的受访者从未实施过LIHR。经皮内环缝合术(PIRS)是所有年龄组的首选技术,9%的青少年首选完全腹膜外和经腹腹膜前修补术。如果存在对侧阴道前突,大多数人(59%)会对其进行修补。男性患者更倾向于采用水压剖腹(21%)和额外的腹腔内器械(42%)。大多数受访者(92%)都保留了远端疝囊。关于复发率的答复各不相同:40%的受访者认为腹腔镜疝气切除术的复发率与开腹手术相当,10%的受访者认为腹腔镜疝气切除术的复发率增加,因此限制了其使用,10%的受访者认为腹腔镜疝气切除术的并发症发生率较低,因此继续使用腹腔镜疝气切除术:结论:PIRS是小儿LIHR的首选。结论:PIRS 是小儿 LIHR 的首选。手术技术各不相同,并受患者性别和年龄的影响。这项调查提供了关于人口统计学、病例选择和小儿外科医生在LIHR方面的方法的见解。
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Analysis of Techniques in Laparoscopic Inguinal Hernia Repairs across Pediatric Age Groups: EUPSA Trainees of European Pediatric Surgery Survey.

Aim:  This survey analyzed techniques in laparoscopic inguinal hernia repair (LIHR) across pediatric age groups.

Materials and methods:  Data were collected through an online survey for pediatric surgeons, comprising of 38 questions, conducted by the European Pediatric Surgeons' Association (EUPSA) Trainees of European Pediatric Surgery (TEPS) LIHR Working Group.

Results:  The survey was completed by 183 surgeons from 22 countries. Seventy-seven percent of respondents had performed LIHR at least once. Regarding preferences about the patient's gender, 7% respondents perform LIHR only in selected females, 9% routinely in females, 15% in both genders with age/weight restrictions, 24% routinely in both genders, 31% in selected cases, and 14% never perform LIHR. Percutaneous internal ring suturing (PIRS) was the preferred technique in all age groups, with totally extraperitoneal and transabdominal preperitoneal repairs preferred by 9% in adolescents. The majority (59%) repaired a contralateral patent processus vaginalis if present. Hydro-dissection (21%) and additional intra-abdominal instruments (42%) were preferred more often for male patients. The distal hernia sac was left intact by most respondents (92%). Responses regarding recurrence rates varied: 40% responded that LIHR had recurrence rates comparable to open surgery, whereas 10% reported increased recurrences and hence limited its use, and 10% consider that slightly increased recurrences are outweighed by lower complication rates associated with laparoscopic methods and thus continue LIHR.

Conclusions:  PIRS is the preferred choice for pediatric LIHR. Surgical techniques vary and are influenced by patient gender and age. The survey gives insights into demographics, case selection, and approaches among pediatric surgeons with regard to LIHR.

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来源期刊
CiteScore
3.90
自引率
5.60%
发文量
66
审稿时长
6-12 weeks
期刊介绍: This broad-based international journal updates you on vital developments in pediatric surgery through original articles, abstracts of the literature, and meeting announcements. You will find state-of-the-art information on: abdominal and thoracic surgery neurosurgery urology gynecology oncology orthopaedics traumatology anesthesiology child pathology embryology morphology Written by surgeons, physicians, anesthesiologists, radiologists, and others involved in the surgical care of neonates, infants, and children, the EJPS is an indispensable resource for all specialists.
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