腹腔镜手术治疗小儿腹股沟嵌顿疝安全性及临床效果的探讨

Dicussion about safety and clinical effect of laparoscopic treatment for inguinal incarcerated hernia in children

目的探讨腹腔镜手术治疗小儿腹股沟嵌顿疝的安全性及临床效果。方法应用腹腔镜治疗小儿腹股沟嵌顿疝31例。结果全组除1例患儿因术中腔镜辅助下难以复位中转行开放手术外，其余30例均成功复位后高位结扎内环口，3例同时行小肠浆膜撕裂修补术，7例同期行对侧隐匿疝治疗，手术时间15—75min，平均30min，住院时间3—5d，平均4d。31例患儿均治愈出院，术后无并发症的发生。结论腹腔镜治疗小儿腹股沟嵌顿疝安全可行、疗效确切，但需注意术前病例选择及术中对嵌顿肠管的观察。

Objective To evaluate the safety and clinical effect of laparoscopic treatment of in- guinal incarcerated hernia in children. Methods Clinical data of the 31 patients hospitalized from July, 2010 to April 2012 were summarized. All of them underwent laparoscopic treatment for inguinal incarcera- ted hernia. The chosen standards, operating methods, invasive risks, attention things and therapeutic out- comes of these cases were analyzed. Results Except 1 child turning to open operation due to difficult reduction, the remaining 30 children all underwent high ligation of inner ring after the incarcerated intestine tube was successfully returned with laparoscopic assistance. Three of the 30 underwent repair operation of small intestine serous membrane in addition, and 7 were treated for predictable occult hernia on the oppo- site side. The operation time changed from 15 to 75 minutes （ mean, 30 minutes ）. Hospitalizing time changed from 3 to 5 days,4 days on average. All 31 children made good recovery with no complications. Conclusion Laparoscopic treatment for inguinal incarcerated hernia in children is safe and effective, but attention should be paid to choosing cases before operation and careful observation on the incarcerated in- testine tube.