腹腔镜下小儿腹股沟斜疝内环口的分型及手术策略

Laparoscopic classification of the internal ring in children with indirect inguinal hernia and the proper operation.

目的探讨小儿腹股沟斜疝腹腔镜下内环口的分型及其临床意义。方法回顾性分析我院2005年7月～2006年12月经微型腹腔镜疝囊高位结扎术治疗的374例腹股沟斜疝患儿的临床资料。结果本组374例,486侧,按腹股沟斜疝内环口分型:巨大型60例:普通型320例:隐蔽型106例。根据不同分型采取腹腔镜下疝囊高位结扎术和紧缩内环口疝囊高位结扎术。均治愈,经6～14个月随访,其中隐蔽型复发1例(0.25%),对侧漏诊1例。结论根据腹股沟斜疝内环口的形态特点,选择不同的手术方法,可以减少小儿腹股沟斜疝术后复发,提高治愈率。

objective To evaluate the anatomic classification of the internal ring in children with indirect inguinal hernia by laparoscopy and to select the proper operation according to the classification. Methods There were consecutive 374 patients undergoing laparoscopic herniorrhaphy in our hospital from July 2005 to December 2006 and their clinical date was reviewed retrospectively. Results 374 cases （486 inguinal henia） were classified as follows： type 1 ,a huge open internal ring; type 2 ,a nomal internal ring; type 3 ,a concealed internal ring. The number of type 1, 2 and 3 was 60,320 and 106. Postoperative follow-up from 6 months to 24 months, 1（1/404 ,0.25%） case in type 3 had recurred, 1 case was missed on the contralateral hernia. Conclusions The internal ring in children with indirect inguinal hernia could be classified into different types according to their laparoscopic features. The classification system is advantageous to select the suitable laparoscopic procedure and reduce the recurrence incidence.