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Analysis on Influencing Factors of Recurrence after Indirect Inguinal Hernia Laparoscopic Surgery
Yuan Cao1, Zhaozheng Ding1, Hongjia Qiang1
1The First People's Hospital of LianYunGang (Pediatric Surgery), Lianyungang 222000, Jiangsu, China.
Insights
Recurrence of indirect inguinal hernia in children after laparoscopic surgery is 5.77%. Male gender, bilateral lesions, and surgical technique influence recurrence, while high ligation and circumferential wiring are protective factors.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hernia Repair
Background:
- Indirect inguinal hernia is common in children.
- Laparoscopic surgery is a frequently used treatment.
- Understanding recurrence factors is crucial for improving outcomes.
Purpose of the Study:
- To analyze the recurrence rate of indirect inguinal hernia in children post-laparoscopic surgery.
- To identify factors influencing postoperative recurrence.
- To guide future prevention and treatment strategies.
Main Methods:
- Retrospective analysis of 260 pediatric patients undergoing laparoscopic surgery for indirect inguinal hernia.
- Data collected via a self-designed questionnaire.
- Univariate and logistic multivariate regression analyses performed to identify influencing factors.
Main Results:
- The recurrence rate was 5.77% (15 out of 400 children).
- Risk factors for recurrence included male gender, bilateral lesions, loose hernia back wall peritoneum, deciduous ligature, incorrect external oblique fascia ligation, large hernia, and early mobilization.
- Exact high ligation and circumferential wiring were identified as protective factors against recurrence.
Conclusions:
- Postoperative recurrence of indirect inguinal hernia in children after laparoscopic surgery is influenced by multiple factors including patient demographics and surgical technique.
- Specific surgical techniques like exact high ligation and circumferential wiring can significantly reduce recurrence risk.
- Risk stratification and tailored interventions are recommended for high-risk pediatric patients.
Abstract:
This paper aims to analyze the recurrence of indirect inguinal hernia in children after laparoscopic surgery and investigate the influencing factors that may lead to recurrence so as to guide the prevention and treatment of postoperative recurrence of this kind of disease in the future. The data of 260 children with indirect inguinal hernia treated by laparoscopic surgery and followed up in our hospital from July 2019 to July 2021 were selected. A self-designed questionnaire was used to collect the basic data. The recurrence was analyzed, and the influencing factors of recurrence were analyzed by univariate analysis and multivariate analysis. Among 400 children after indirect inguinal hernia laparoscopic surgery, an occurrence was observed in 15 children, and the recurrence rate was 5.77%. Univariate analysis showed that the age and course of disease were not correlated with recurrence after indirect inguinal hernia laparoscopic surgery (P > 0.05). Being male, bilateral lesions, exact high ligation, loose hernia back wall peritoneum, deciduous ligature, incorrect ligation of the fascia of musculus obliquus externus abdominis, large inguinal hernia, circumferential wiring, and too early off-bed activity were the influencing factors of recurrence after indirect inguinal hernia laparoscopic surgery (P < 0.05). Logistic multivariate regression analysis showed that being male, bilateral lesions, loose hernia back wall peritoneum, deciduous ligature, incorrect ligation of the fascia of musculus obliquus externus abdominis, large inguinal hernia, and too early off-bed activity were the influencing factors of recurrence after indirect inguinal hernia laparoscopic surgery (OR>1, P < 0.05). Exact high ligation and circumferential wiring were protective factors of recurrence after indirect inguinal hernia laparoscopic surgery (OR>1, P < 0.05). After indirect inguinal hernia laparoscopic surgery, recurrences were affected by many factors, such as gender, site of pathological changes, and loose hernia back wall peritoneum. For these children with risk factors, reasonable intervention should be taken to reduce recurrence; exact high ligation and circumferential wiring are the protective factors. If permitted, the children meeting related indications can be treated by high ligation or circumferential wiring to reduce the risk of recurrence after indirect inguinal hernia laparoscopic surgery.
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