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.
Highlights
Indirect inguinal hernia is common in pediatrics, and most of them are treated with surgery
Single Factor Analysis of the Recurrence of Children with Indirect Inguinal Hernia after Surgery. e preliminary univariate test results showed that the age and course of disease were not related to the recurrence of children with an indirect inguinal hernia after laparoscopic single-site laparoscopic surgery (P > 0.05); male, bilateral onset, exact high ligation, posterior hernia wall peritoneum laxity, loss of hernial sac ligation line, the misligation of external oblique muscle fascia, huge hernia, cerclage, and premature getting out of bed after operation may all be the influencing factors of postoperative recurrence (P < 0.05). e results are shown in Tables 1 and 2
Multivariate Logistic Regression Analysis. e variables preliminarily confirmed as influencing factors by the single factor test were included and assigned, including gender, location of onset, exact high ligation, peritoneal relaxation of the posterior wall of hernia, loss of ligation line of hernia sac, the misligation of external oblique fascia, giant hernia, ring ligation, and early getting out of bed after the operation
Summary
Indirect inguinal hernia is common in pediatrics, and most of them are treated with surgery. The main minimally invasive surgery for inguinal hernia is laparoscopic surgery. Laparoscopic surgery has the advantages of less trauma, light postoperative pain, and concealed incision. It is accepted and recognized by the majority of medical workers and their families [2, 3]. For some complex inguinal hernias, including giant hernias, and incarcerated hernias, there is still a risk of recurrence after minimally invasive surgery. Erefore, early identification of the risk factors that may lead to the recurrence of children with indirect inguinal hernia after laparoscopic surgery and timely formulation and implementation of intervention strategies for the factors are of great significance to reducing recurrence. There are many related studies on the factors affecting the recurrence of children with an indirect
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