婴儿腹腔镜手术联合内环缝扎术

Combined laparoscopic operation for infants with patent processus vaginalis

目的探讨婴儿腹腔镜手术联合内环缝扎术的可行性、必要性和优越性。方法回顾性分析16例婴儿腹腔镜手术联合内环缝扎术的临床资料,并将14例腹腔镜幽门环切术联合内环缝扎术与25例单纯腹腔镜幽门环切术进行对比。结果16例腹腔镜联合手术顺利,无近期并发症。其中14例腹腔镜幽门环切术联合内环缝扎术,与腹腔镜下幽门环切术单脏器手术比较,术后进食时间、住院时间等指标与对照组比较无显著性差异(P>0.5);手术时间有显著差异(P<0.001),2次单脏器手术的医疗费用总和是2个脏器联合手术的1.33倍。结论婴儿腹腔镜手术时,对合并腹股沟疝或术中发现鞘状突未闭,并符合潜在腹股沟疝/交通性鞘膜积液标准的患儿,可联合行内环高位缝扎术;同时提出潜在腹股沟疝/交通性鞘膜积液的标准。

Objective To explore the feasibility, necessity and superiority of combined laparoscopic procedures in infants with inguinal hernia or patent processus vaginalis. Methods The records of 16 patients with laparoscopic surgical procedures combined with laparoscopic inguinal herniorrhaphy or patent processus vaginalis repairing were retrospectively reviewed. Laparoscopic inguinal herniorrhaphy or patent processus vaginalis repairing were performed on 14 infants underwent laparoscopic pyloromyotomy and 2 with laparoscopic abdominal exploration. The duration of operation, fasting time after operation and hospital stays in these patients were compared to those underwent single laparoscopic procedure. Results All combined surgical procedures were successfully accomplished without complications. There was no significant difference of fasting time, the time of intravenous fluid and antibiotics administration, and hospital stays between combined and single operation. However, the total cost in single group was 1.33 times of that in combined group. Conclusions Combined laparoscopic operation is a safe and less cost procedure for infants suffered from abdominal diseases complicated with inguinal hernia or hydrocele.