腹腔镜治疗小儿疝及鞘膜积液180例报告

Laparoscopic treatment of inguinal hernia and hydrocele of tunica vaginalis in children:a report of 180 cases

目的：探讨腹腔镜治疗小儿腹股沟斜疝及交通性鞘膜积液的新方法。方法：行腹腔镜手术治疗小儿腹股沟斜驰及交通性鞘膜积液180例，其中小儿腹股沟斜疝150例，右侧80例，左侧40例，双侧30例；单侧斜疝中20例有对侧隐性疝；交通性鞘膜积液30例，右侧20例，左侧10例。均在腹腔镜下行内环口荷包缝合高位结扎术＋积液抽出术。结果：手术时间单侧疝平均5-10min，双侧疝10～20min。术后平均1．5d出院，皮肤切口无需缝线。无并发症发生。随访6～24个月，平均12个月，未见复发。结论：腹腔镜下内环口高位结扎术＋积液抽出术具有安全有效、创伤小、无瘢痕、康复快、住院时间短、操作简便、无需特殊器械等优点，无阴囊感染、睾丸扭转及缺血坏死、切口感染、髂腹沟及髂腹下神经损伤、腹股沟区疼痛麻木等并发症发生，疗效满意。

Objective：To explore a new method of laparoscopy in treatment of indirect inguinal hernia and the hydroeele of tunica vaginalis in children. Methods： One hundred and eighty cases with indirect inguinal hernia and the hydrocele of tunica vaginalis were treated by laparoseopic surgery. Among them, 150 cases had indirect inguinal hemia（ right ：80 cases,left ：40 cases, bilateral：30 cases ） , 20 cases had contralateral latent hernia in the unilateral hemias, and 30 cases （right ：20 cases, left：10 cases）with the hydroeele of tunica vaginalis. All patients underwent internal orifice high ligation with laparoscopy, and the hydrocele of tunica vaginalis was drawn out. Results：The average operative time was 5-10min in unilateral hernia and 10-20min in bilateral hernia. The mean postoperative hos- pitalization was 36h. Skin sutures were not required. All patients were followed-up for 6-24months （mean 12 months） ,and no complications and recurrence occurred. Conclusions：Laparoscopic high ligation surgery and removal of the hydrocele of tunica vaginalis is a simple, satisfactory,effective, and minimaliy invasive surgical method. It causes no infection in the wound cut, scrotum and testis, no nerve damage, no pain and numb in lower abdomen.