[1]刘雪来**叶茂孙婧瑄陈钰嫱.儿童斜疝腹腔镜经皮腹膜外内环结扎术后线结反应的处置[J].中国微创外科杂志,2025,01(12):762-765.
　Liu Xuelai,Ye Mao,Sun Jingxuan,et al.Management of Postoperative Suture Knot Reactions Following Laparoscopic Percutaneous Extraperitoneal Closure for Pediatric Indirect Inguinal Hernia[J].Chinese Journal of Minimally Invasive Surgery,2025,01(12):762-765.
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儿童斜疝腹腔镜经皮腹膜外内环结扎术后线结反应的处置()

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2025年12期
页码:
762-765
栏目:
经验交流
出版日期:
2025-12-25

文章信息/Info

Title:
Management of Postoperative Suture Knot Reactions Following Laparoscopic Percutaneous Extraperitoneal Closure for Pediatric Indirect Inguinal Hernia
作者:
刘雪来**叶茂孙婧瑄陈钰嫱
(首都医科大学附属首都儿童医学中心普通外科，首都儿科研究所，北京100020)
Author(s):
Liu Xuelai;  Ye Mao;  Sun Jingxuan;  et al.
Department of General Surgery, Capital Center for Children’s Health, Capital Medical Univerisity, Capital Institute of Pediatric Surgery, Beijing 100020, China
关键词:
腹腔镜手术; 经皮腹膜外闭合; 斜疝; 线结反应
Keywords:
Laparoscopy; Percutaneous extraperitoneal closure; Indirect inguinal hernia; Suture knot reaction
文献标志码:
B
摘要:
目的总结儿童斜疝单孔腹腔镜经皮腹膜外内环结扎术后线结反应处置的初步经验。方法2019年9月~2024年10月，接诊单孔腹腔镜经皮腹膜外内环结扎术后线结反应8例。右侧斜疝5例，左侧斜疝3例。男6例，女2例。年龄1岁3个月~9岁，中位年龄4.5岁。术后1~3周开始出现红肿和局部皮下包块，其中2例破溃。就诊当日换药(碘伏局部消毒+莫比罗星软膏局部涂抹)，每3天换药一次，连续5次，之后每5天换药至术后12周，取出线结。结果2例就诊时局部已经破溃，6例换药后5~7天包块破溃，颜色变浅，淡血性渗出，均于破溃后1~2周(术后2~5周)出现肉眼可见的线头，但包块未见明显缩小。7例术后12周剪断和取出线结，1例换药至术后10周于当地医院剪断和取出线结。取出线结后3~6个月均行彩超检查，显示腹股沟管与腹腔未见相通。随访13个月~6年1个月，中位时间2年6个月，腹股沟区未出现包块。结论儿童斜疝术后如发生线结反应，坚持换药至术后12周再行去除线结是一种安全、有效的治疗方法。
Abstract:
ObjectiveTo explore the preliminary experience of management of postoperative suture knot reactions following singleport laparoscopic percutaneous extraperitoneal closure (SPLPEC) for pediatric indirect inguinal hernia.MethodsFrom September 2019 to October 2024, 8 children developed postoperative suture knot reactions after SPLPEC. There were 5 cases of rightsided indirect inguinal hernia and 3 cases of leftsided hernia. Among them, there were 6 boys and 2 girls. The age range was 1 year and 3 months to 9 years, with a median age of 4.5 years old. Postoperative suture knot reactions manifested as localized redness, swelling, and subcutaneous nodules at the abdominal wall at 1-3 weeks postoperatively, with subsequent gradual nodule rupture in 2 cases. On the day of the clinic visit, the dressing was changed (local disinfection with povidoneiodine and topical application of mupirocin ointment), with subsequent changes every 3 d for 5 consecutive sessions. Afterward, dressings were changed every 5 d until postoperative week 12, followed by suture knot removal.ResultsIn 2 cases, localized ulceration was already present at the initial visit. In 6 cases, the mass ulcerated after 5-7 d of dressing changes, exhibiting lightened coloration and serosanguinous exudate. Visible suture material emerged in all the cases within 1-2 weeks after ulceration (2-5 weeks after surgery), though no significant reduction in mass size was observed. Sutures were cut and removed at 12 weeks postoperatively in 7 cases, while 1 case had sutures removed at a local hospital during week 10. Color Doppler ultrasonography was performed in 3-6 months after suture knot removal to confirmed no communication between the inguinal canal and abdominal cavity. During followup periods ranging from 13 months to 6 years and 1 month (median, 2 years and 6 months), no recurrent masses developed in the inguinal region.ConclusionFor postoperative suture knot reactions in pediatric indirect inguinal hernia, persistent wound care until postoperative week 12 followed by suture knot removal is a safe and effective treatment approach.

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备注/Memo

备注/Memo:
基金项目：北京市自然科学基金(7222015)；首都儿科研究所所级课题(LCYJ-2023-07)；北京市卫生健康委员会2024-2025年度“一带一路”国际卫生健康合作项目和世界卫生组织合作中心项目**通讯作者，Email：liuxuelai_steven@163.com
更新日期/Last Update: 2026-01-14