Comparative analysis between one-step and two-step puncture assisted laparoscopic high ligation of hernia sac in the treatment of indirect inguinal hernia in children

Abstract

Objective To assess the clinical efficacy and safety of one-step puncture method(using clamp type needle) versus two-step puncture method(using epidural needle) in pediatric laparoscopic high ligation of indirect inguinal hernia sac. Methods Retrospect review was conducted to 147 pediatric patients (≤120 cm in height) with unilateral indirect inguinal hernia(≤1.5 cm in diameter of hernial neck) in our hospital from March 2015 to June 2018, in which 64 cases were performed with epidural needle (two-step puncture method), and 83 cases were done with clamp type needle (one-step puncture method). Perioperative data were presented as (±s, and compared via independent two sample t test. One-year recurrence rates were analyzed using the χ2 test. SPSS statistical software (version 17.0) was used for all the analysis, at a significance level of P<0.05. Results There was no difference between the two groups in regard to the duration of surgery [(11.8±3.2) min vs. (12.4±2.9) min], intraoperative blood loss [(1.7±1.3) ml vs. (1.9±1.3) ml], incidence of occult contralateral hernia [n=10(12.0%) vs. n=8(12.5%)], pain score at 24 hours after surgery [(1.2±0.6) vs. (1.3±0.5)], incidence of scrotal or labial edema [n=0(0%) vs. n=1(1.6%)], hospitalization time [(2.1±1.1) d vs. (2.2±1.1) d], and one-year recurrence rates [2.4% (2/83) vs. 3.1% (2/64)]. Conclusion For pediatric patients (≤120 cm in height) with unilateral indirect inguinal hernia(≤1.5 cm in diameter of hernial neck) who underwent laparoscopic high ligation of indirect inguinal hernia sac, both one-step puncture method and two-step puncture method can achieve satisfactory clinical effects, with similar one-year recurrence rates. Key words: Hernia, inguinal; Child; Laparoscopy; Ligation