经脐单部位腹腔镜治疗隐睾临床探讨

Clinical Study of Laparoscopic Treatment of Cryptorchidism by Umbilical Single Site

目的探讨经脐单部位腹腔镜治疗小儿隐睾的可行性、安全性及临床优势。方法选择该院2017年3月—2018年6月隐睾患儿86例,随机分为手术单部位组和手术三孔组,各43例。手术单部位组实施经脐单部位腹腔镜睾丸固定术;手术三孔组应用三孔腹腔镜睾丸固定术。评估两组患者手术基本情况及预后,并比较两组患者术中、术后并发症。结果手术单部位组患儿手术切口、术中出血量、术后疼痛评分、术后排气时间分别为(1.02±0.20)cm、(6.73±1.05)min、(4.35±0.14)mL、(13.21±1.28)h,均低于手术三孔组,差异有统计学意义(t=8.39,9.70,8.62,9.94,P<0.05)。手术单部位组患儿气腹时间为(19.33±4.64)min,高于手术三孔组,差异有统计学意义(t=10.26,P<0.05)。两组患儿手术时间比较,差异无统计学意义(t=5.31,P>0.05);手术单部位组患儿手术满意度评分为(98.02±0.35)分,高于三孔组(93.89±3.24)分,差异有统计学意义(t=10.86,P<0.05);两组术中和术后均未出现并发症。结论腹腔镜对隐睾患儿手术治疗具有优势,均有较高的安全性,与三孔腹腔镜睾丸固定术比较,单部位操作更具有损伤较小、满意度高等优势,可作为隐睾腹腔镜手术的优选入路。

Objective To investigate the feasibility, safety and clinical advantages of laparoscopic single-site laparoscopic treatment of cryptorchidism in children. Methods 86 children with cryptorchidism from March 2017 to June 2018 were enrolled in this study. They were randomly divided into surgical single-study group and surgical threehole group, with 43 cases in each group. Single-site laparoscopic testicular fixation was performed in the single-operative group. Three-hole laparoscopic testicular fixation was performed in the threehole group. The basic conditions and prognosis of the two groups were evaluated, and the intraoperative and postoperative complications were compared between the two groups. Results The surgical incision, intraoperative blood loss, postoperative pain score and postoperative exhaust time were(1.02 ±0.20) cm,(6.73±1.05)mL,(4.35±0.14)points,(13.21±1.28)h were lower than those in the surgical threehole group, and the difference was statistically significant(t=8.39, 9.70, 8.62, 9.94, P<0.05). The pneumoperitoneum time in the single-study group was(19.33±4.64) min, which was higher than that in the threehole group(t=10.26, P<0.05). There was no significant difference in the operation time between the two groups(t=5.31, P>0.05). The surgical satisfaction score of the singlesite group was(98.02±0.35)points, which was higher than that of the threehole group(93.89±3.24)points. The difference was statistically significant(t = 10.86, P<0.05);no complications occurred during or after surgery. Conclusion Laparoscopy has advantages in surgical treatment of cryptorchidism, and it has higher safety. Compared with threehole laparoscopic testicular fixation, singlesite operation has the advantages of less damage and higher satisfaction. It can be used as preferred approach to cryptorchidism and abdomi-nal cavity vitectomy.