经腹疝囊腹膜外旷置术治疗小儿疝68例临床分析

Treatment of children with hernia by transabdominal extraperitoneal hernia sac exclusion in 68 cases

目的探讨小儿疝更加优化的手术治疗方式。方法回顾性分析2004～2010年我科收治的68例小儿疝的临床资料。结果均为诊断明确的小儿腹股沟斜疝病例。在不插管的静脉基础麻醉（丙泊酚＋芬太尼）下，行经腹疝囊腹膜外旷置术，术后随访仅1例复发。结论经腹疝囊腹膜外旷置术是在疝囊高位结扎基础上进行的有益探索，将疝囊旷置于腹膜外，疗效确切，具有操作简便、安全、不破坏小儿腹股沟区原有解剖、术后恢复快等特点，优于传统的疝囊高位结扎术，但仍应掌握好手术技巧及麻醉方法。

Objective To explore the optimized surgical treatment for children with hernia. Methods Retrospective analysis was made in the clinical data of 68 children with hernia hospitalized in our department between 2004 and 2010. Results All cases were definitely diagnosed as pediatric oblique inguinal hernia. Under the intravenous basal anesthesia （ propofol plus fentanyl） （ no intubation） ,extraperitoneal hernia sac exclusion was carried out. During the follow-up after the operation, only one case recurred. Conclusion Transabdominal extraperitoneal hernia sac exclusion has definite curative effect and the advantages of simple operation, safety, no destruction to the original pediatric inguinal anatomy, and rapid recovery after the treatment. It is superior to the traditional high ligation of hernia sac, but the surgical technique and anesthestie method should be correctly grasped.