腹腔镜与开放式手术治疗小儿腹股沟斜疝对比研究

A comparative study of open versus laparoscopic herniorrhaphy in pediatric inguinal herni

目的对比观察腹腔镜下小儿腹股沟斜疝疝囊高位结扎与传统开放式疝囊高位结扎术治疗效果。方法随机抽取该院小儿外科腔镜中心2007年1月～2011年4月收治600例小儿腹股沟斜疝与同期小儿普外组收治600例腹股沟斜疝进行比较分析。结果小儿腹腔镜组术中出血、术后恢复明显低于开放手术组,腔镜组术中发现523例单侧腹股沟斜疝合并对侧鞘状突未闭193例(37%),并避免解剖腹股沟管结构,无开放手术组术中出血、睾丸萎缩、医源性隐睾、肠粘连等并发症。结论腹腔镜技术治疗小儿的腹股沟斜疝是安全的,具有损伤小、疼痛轻、操作简单、疗效可靠及恢复快等优点,是比较理想的手术方式,值得推广。

[Objective] To compare the clinical outcomes between laparoscopic and traditional herniorrhaphy in pediatric inguinal hernia.[Methods] From January 2007 to April 2011,600 children with indirect inguinal hernia underwent laparoscopic high ligation and the other 600 children underwent traditional high ligation.Perioperative data were collected and analyzed.[Results] The duration of operation,the time of complete recovery and amount of blood loss were significantly shorter and less in laparoscopic high ligation than traditional open surgery.The overall incidence of a patent processus vaginalis on contralateral examination was 37%（193 of 523）.Laparoscopic repair of inguinal hernia could avoid a difficult dissection in groin,and the procedure under the superior magnification of a laparoscope would greatly reduce the incidence of vas and vascular injury,and no complications such as testicular atrophy and iatrogenic cryptorchidism was observed.[Conclusion] Laparoscopic repair of inguinal hernia is a safe and effective procedure,with the advantages of minimal invasion,simplicity of operation,rapid recovery and so on,and is worth to be introduced.