腹腔镜小儿阑尾切除术联合鞘状突未闭高位结扎术

Laparoscopic Appendectomy Combined with High Ligation of the Vaginal Process in Children

目的总结腹腔镜小儿阑尾切除术联合鞘状突未闭高位结扎术的临床经验。方法三孔法腹腔镜阑尾切除术中常规探查双侧腹股沟区,对鞘状突未闭(单侧69例,双侧17例)同时行鞘状突未闭高位结扎术。结果83例行腹腔镜阑尾切除术联合鞘状突末闭高位结扎术,无术后并发症。83例随访6～12个月,平均10个月,仅1例腹股沟斜疝复发。3例隐性疝未处理(1例因开展腹腔镜初期缝合技术不成熟,2例因阑尾穿孔盆腔脓性液较多)。结论腹腔镜小儿阑尾切除术联合鞘状突未闭高位结扎术在一次麻醉下完成2种或多种病变的处理,避免多次手术的打击,降低手术成本,具有创伤小、痛苦轻、恢复快、美观的优点。

Objective To summarize our experience on laparoscopic appendectomy combined with high ligation of the vaginal process in children. Methods From January 2004 to May 2007, totally 326 patients with appendicitis underwent laparoscopic appendectomy in our hospital. During the operation, by inguinal exploration, 83 cases of vaginal process deformity （ 17 bilateral and 69 unilateral lesions） were confirmed. High ligation of the vaginal process was performed on these patients. Results The operation was successfully done in all of the 83 cases, none of them showed postoperative complications. The cases were followed up for 6 to 12 months, during which only one patient had recurrent inguinal hernia. Three patients developed latent hernia but recelned no treatment. Conclusions Laparoscopic appendectomy combined with high ligation of the vaginal process is an safe, effective, and low-cost procedure, leading to quick recovery and less pain for children with appendicitis complicated with vaginal process deformity.