腹腔镜下单孔法治疗小儿腹股沟斜疝的优势探讨

Superority of one-port laparoscopic method for treatment of inguinal hernia in children

目的通过比较腹腔镜下单孔法及双孔法治疗小儿腹股沟斜疝的临床应用,探讨腹腔镜下单孔法在治疗小儿腹股沟斜疝中的优势。方法通过回顾性分析我科自2006年1月至2011年3月收治的80例小儿腹股沟斜疝患儿,分别采用腹腔镜下双孔法及单孔法缝扎腹股沟斜疝单侧疝囊内环治疗,每组各收治40例,年龄在6个月到5岁范围。结果在缝合正常大小内环口的病例中,腹腔镜下单孔法缝扎单侧内环口操作时间平均为11.8min(手术用时范围10～13min),双孔法操作平均时间为12.3min(手术用时范围11～14min);而在缝合较大内环口的用时时间上,单孔法手术用时明显较双孔法手术时间短(11.3min,14.23min)。术后随访平均6个月(3个月～1年),手术患儿均无腹股沟斜疝复发。结论相比较腹腔镜下双孔法高位结扎腹股沟疝疝囊,采用腹腔镜下单孔法高位缝扎腹股沟斜疝疝囊,不仅具有美观、创伤小的优势,同时操作时间较短,更适合治疗较大内环口的腹股沟斜疝。

Objective To investigate the curative effect on one-port and two-port laparoscopic method for the treatment of indirect inguinal hernia in children. Methods From January 2006 to March 2011, the data of 80 cases aged from 6 month to 5 years old with inguinal hernia were analyzed retrospectively. Among them, the high ligation of hernia sac was performed by one-port and two-port method （n =40, each）, respectively. Results All cases were performed successfully, the mean operating time of normal size of internal ring in inguinal hernia was 11.8 minutes （range 10-13） in one-port group and 12.3 minutes （range 11-14） in two-port LH group, but the mean operating time in one-port group was shorter than that in two-port group for large size of internal ring in inguinal hernia （11.3 versus 14.23 ）. The mean follow-up period was 6 months （3-12 months） and there were no recurrence. Conclusion Compared with two-port laparoscopic method, the one-port laparoscopic high ligation of hernia sac has many advantages for treating indirect inguinal in children, such as less trauma, a nice looking and shorter operation time. It is especially suitable to the treatment of large internal ring in indirect inguinal hernia.