摘要
目的探讨治疗青少年男性腹股沟疝的最佳手术方式。方法采取问卷调查研究,以一位16岁男性腹股沟斜疝患者为例,设定不同内环口缺损直径大小(1 cm、4 cm)和不同BMI(20 kg/m^(2)、35 kg/m^(2))的4种情况,邀请外科医师在开放或腔镜疝囊高位结扎、开放或腔镜不可吸收补片修补、开放或腔镜生物补片修补以及开放组织缝合修补等七项术式中作出最佳选择,问卷内容还包含医师的专业范围、所属医院级别和技术职称。结果共获得128份有效问卷。结果83份(64.8%)为普通外科医师(包括疝外科),45份(35.2%)为儿外科医师。当患者BMI=20kg/m^(2)、内环口缺损直径为1 cm时,84.4%的普通外科医师选择成人型修复(补片或组织缝合修复),而78.8%的儿外科医师选择疝囊高位结扎;当内环口缺损直径增大至4 cm时,86.8%的普通外科医师和55.6%的儿外科医师选择不可吸收补片修补。当患者BMI=35 kg/m^(2)、内环口缺损为1 cm时,79.5%的普通外科医师和82.2%的儿外科医师选择腹腔镜手术;当内环口缺损直径增大至4 cm时,73.5%的普通外科医师和75.6%的儿外科医师选择腹腔镜手术。结论关于青少年男性腹股沟疝的修补方式,儿外科医师与普通外科医师的选择倾向不同,所以目前的决定因素是术者的从业类型,而不是疾病本身的特点。
Objective To investigate the best surgical method for adolescent male inguinal hernia.Methods A 16-year-old male patient with indirect inguinal hernia was taken as an example.Four conditions were set with different diameter sizes(1 cm,4 cm)and different BMI sizes(20 kg/m^(2),35 kg/m^(2))of internal ring defect.Surgeons were invited to make the best choice among seven surgical procedures,including open or endoscopic high ligation of hernia sac,open or endoscopic non-absorbable patch repair,open or endoscopic biological patch repair,and open tissue suture repair.The questionnaire also included the professional scope,hospital level and technical title of the doctors.Results A total of 128 valid questionnaires were obtained.83(64.8%)were general surgeons(including hernia surgeons)and 45(35.2%)were pediatric surgeons.83(64.8%)were general surgeons(including hernia surgeons)and 45(35.2%)were pediatric surgeons.When the BMI of the patient was 20 kg/m^(2) and the diameter of the inner ring defect was 1 cm,84.4% of the general surgeons chose adult repair(mesh or tissue suture repair),and 78.8% of the pediatric surgeons chose high ligation of the hernia sac.When the diameter of the inner.innular defect increased to 4 cm,86.8% of general surgeons and 55.6% of pediatric surgeons chose nonabsorbable mesh repair.When BMI=35 kg/m^(2) and internal annular defect was 1 cm,79.5% of general surgeons and 82.2% of pediatric surgeons chose laparoscopic surgery.When the diameter of the defect increased to 4 cm,73.5% of general surgeons and 75.6% of pediatric surgeons chose laparoscopic surgery.Conclusion With regard to inguinal hernia repair in adolescent males,the preference of pediatric surgeons is different from that of general surgeons,so the type of practitioner,rather than the disease itself,is now the determining factor.
出处
《浙江临床医学》
2021年第10期1428-1430,共3页
Zhejiang Clinical Medical Journal
基金
浙江省基础公益研究计划(LGF19H030015)
杭州市卫生科技计划项目(2018A11)。
关键词
青少年男性
腹股沟疝
手术方式
问卷调查
Adolescent males
Inguinal hernia
Surgery methods
Questionnaire survey
