圆形韧带在经皮腹股沟疝修补术中的应用:女孩FLAIR技术的比较结果。

IF 1.4 3区 医学 Q2 PEDIATRICS
Anas Shikha, Zahraa Zaghloul, Mashal Ahmed, Khalid Eltaeb, Janice Wong
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引用次数: 0

摘要

开窗腹腔镜辅助内环修补术(FLAIR)是一种精细的经皮儿科腹股沟疝修补技术。虽然其结果已报道在男孩,其应用在女孩,特别是有关圆韧带管理,仍未充分探讨。是否包括或排除韧带内环关闭仍有争议。本研究评估圆形韧带管理对女孩FLAIR手术结果的影响。回顾性分析了2016年7月至2023年12月期间手术的69例疝气患者。将患者分为两组:封闭圆形韧带组(纳入组)和故意保留圆形韧带组(排除组)。比较两组的复发率及术后并发症。所有4例复发(11%)均发生在纳入组,而排除组无复发(p = 0.048)。术后3个月内全部复发,均经排除术成功再手术,随访无复发。其他术后并发症组间无明显差异。FLAIR在女孩中似乎是一种安全有效的方法,特别是当圆形韧带被排除在闭合之外时。排除与零复发和无并发症增加相关。在中期随访中观察到的这些发现表明,保留圆形韧带可以增强修复的完整性,并可能保护韧带免受夹持,从而保留其解剖功能。需要更大规模的多中心随访研究来验证这些结果并指导小儿疝修补策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Round Ligament Management in Percutaneous Inguinal Hernia Repair: Comparative Outcomes Using the FLAIR Technique in Girls.

Fenestrated laparoscopic-assisted internal ring-rrhaphy (FLAIR) is a refined percutaneous technique for pediatric inguinal hernia repair. Although its outcomes have been reported in boys, its application in girls, particularly in relation to round ligament management, remains underexplored. Whether to include or exclude the ligament during internal ring closure is still debated.This study evaluated the impact of round ligament management on surgical outcomes in girls undergoing FLAIR. A retrospective cohort of 69 hernias, operated on between July 2016 and December 2023, was reviewed. Patients were divided into two groups: those in whom the round ligament was included in the closure (Inclusion group) and those in whom it was deliberately spared (Exclusion group). Recurrence rates and postoperative complications were compared.All four recurrences (11%) occurred in the Inclusion group, while no recurrences were observed in the Exclusion group (p = 0.048). All recurrences occurred within 3 months postoperatively and were successfully reoperated using the exclusion technique, with no further recurrence during follow-up. No significant differences in other postoperative complications were identified between groups.FLAIR appears to be a safe and effective approach in girls, particularly when the round ligament is excluded from the closure. Exclusion was associated with zero recurrences and no increase in complications. These findings, observed over intermediate-term follow-up, suggest that sparing the round ligament may enhance repair integrity and potentially protect the ligament from entrapment, thereby preserving its anatomical function. Larger, multicenter studies with extended follow-up are needed to validate these results and guide pediatric hernia repair strategies.

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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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