青少年间接腹股沟疝气的腹腔镜与开放式疝气修补术:回顾性队列研究。

IF 2.1 4区 医学 Q2 SURGERY Journal of Investigative Surgery Pub Date : 2024-12-01 Epub Date: 2024-11-17 DOI:10.1080/08941939.2024.2427382
Haipeng Wang, Xiaolei Wang
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引用次数: 0

摘要

背景和目的:青少年腹股沟疝(IH)修补术的最佳手术方法尚未确定。本研究旨在分析和比较采用腹腔镜(LHR)与开腹疝修补术(OHR)治疗的青少年 IH 患者的围手术期结果和长期疗效:本研究回顾性分析了2012年3月至2018年2月在新乡市中心医院接受LHR或OHR初次治疗的青少年IH患者的临床病理资料。采用单变量和多变量Cox回归分析确定了与患者预后相关的临床病理因素。采用 Kaplan-Meier 法生成不同队列患者的无复发生存期(RFS)曲线,并采用对数秩检验进行比较。倾向评分匹配(PSM)分析用于按1:1的比例匹配LHR组和OHR组患者:入组的青少年 IH 患者包括 243 名 LHR 组患者和 252 名 OHR 组患者。经过PSM后,两组各有189名患者配对成功。与 OHR 组相比,LHR 组住院时间更短、失血量更少、术后总体并发症更少、复发率和慢性疼痛率更低。在PSM前后,LHR组的RFS明显优于OHR组:青少年 IH 患者可以安全地进行腹腔镜腹股沟疝修补术,并获得良好的围手术期和长期疗效。
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Laparoscopic Versus Open Hernia Repair for Indirect Inguinal Hernia in Adolescents: A Retrospective Cohort Study.

Background and purpose: The optimal surgical approach for inguinal hernia (IH) repair in adolescents has not been established. This study aimed to analyze and compare the perioperative results and long-term outcomes of adolescent patients with IH treated with laparoscopic (LHR) versus open hernia repair (OHR).

Methods: This study retrospectively reviewed the clinicopathological data of adolescent patients with IH who underwent LHR or OHR as initial treatment from March 2012 to February 2018 at Xinxiang Central Hospital. Clinicopathological factors associated with the prognosis of patients were identified using univariate and multivariate Cox regression analysis. Recurrence-free survival (RFS) curves between different cohorts of patients were generated using the Kaplan-Meier method and compared using the log-rank test. Propensity score matching (PSM) analysis was used to match patients of the LHR and OHR groups in a 1:1 ratio.

Results: Adolescent patients with IH were enrolled, including 243 patients in the LHR group and 252 patients in the OHR group. After PSM, 189 patients were matched in each of the study group. Compared with the OHR group, the LHR group had a shorter hospitalization, less blood loss, fewer overall postoperative complications and lower rates of recurrence and chronic pain. The LHR group had a significantly better RFS than the OHR group before and after PSM.

Conclusions: Laparoscopic inguinal hernia repair for adolescent patients with IH can be safely performed with favorable perioperative and long-term outcomes.

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来源期刊
CiteScore
4.20
自引率
0.00%
发文量
114
审稿时长
6-12 weeks
期刊介绍: Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.
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