微型腹腔镜下小儿腹股沟疝高扎术的改良研究

Study of modified laparoscopic high ligation operation of inguinal hernia in children

目的 介绍一种改良腹腔镜小儿疝囊高位结扎术的方法,探讨进一步减少创伤,防止复发,扩大适应范围,美容效果更好的腹股沟斜疝手术方法. 方法 将2007年1月至2012年4月收入本院的392例腹股沟斜疝患儿随机分为两组.一组采取既往两孔法腹股沟疝疝囊高位结扎术,为未改良组,另一组采取镜头拨挂线单孔及皮下间隔进针法完成腹腔镜下疝囊高位结扎术,为改良组.两组患儿均随访半年至5年,比较两组术中及术后多项临床指标. 结果 改良组和未改良组手术时间、术中出血量、术后下床活动时间、住院天数等指标比较,P值均＞0.05,差异无统计学意义；而在脐旁戳孔例数,巨大疝转开腹手术例数,术后复发例数等方面比较,P值均＜0.05,差异有统计学意义.结论 镜头拨挂线单孔及皮下间隔进针法行疝囊高位结扎术,较两孔法疝囊高位结扎术创伤更小,适应范围更广,复发率更低,美容效果更理想.

Objetive To introduce a modified laparoscopic pediatric hernia sac high ligation method,further reduce the trauma,prevent recurrence,expand the range and better cosmetic effect of inguinal hernia surgery method.Method In January 2007 to April 2012 income in our hospital 392 cases of inguinal hernia patients randomly divided into two groups.A group take always two hole method of inguinal hernia sac high technique,for not improved group,another group to take camera hanging line puckering and subcutaneous interval into complete laparoscopic high ligation of hernial sac stitch,for improved group.Two groups of children were followed up for six months to five years,compared two groups of intraoperative and postoperative clinical indicators.Results Improved group and not improved group in operation time,intraoperative blood loss,postoperative bed activity time,hospitalization days,such as index comparison,P ＞ 0.05,there was no statistically significant difference,And beside the umbilical trocar hole cases,huge hernia operation cases,cases of postoperative recurrence and so on,P ＜ 0.05,the differences were statistical significance.Conclusion Camera hanging line puckering and subcutaneous interval into stitch hernia sac high technique from two hole method hernial sac surgery less trauma,to adapt to a wider range,lower recurrence rate,and the cosmetic effect is more ideal.