腹腔镜疝囊高位结扎术治疗小儿腹股沟疝的临床体会

Clinical study of laparoscopic hernia sac high ligation in the treatment of pediatric inguinal hernia

目的:探讨腹腔镜疝囊高位结扎术治疗小儿腹股沟疝的临床价值及手术方法、优缺点。方法:对比分析843例腹腔镜疝囊高位结扎术(腹腔镜组)与519例传统开放疝囊高位结扎术(开放组)的临床资料,观察两组患儿手术时间、住院时间、术中出血量、隐匿疝的发现、麻醉安全性、术后并发症及住院费用等指标。结果:两组患儿均治愈。腹腔镜组手术时间、住院时间、术中出血量、隐匿疝的发现、麻醉安全性及术后并发症明显优于开放组,住院费用略高于开放组,差异均有统计学意义(P<0.05)。腹腔镜组复发1例,复发率0.1%;开放组复发11例,复发率2.1%。结论:腹腔镜疝囊高位结扎术具有操作简单、患者创伤小、术后康复快、麻醉安全性高、术后并发症少等明显优势,术中可及时发现并同时处理对侧隐匿疝、双侧疝。

Objective：To discuss the clinical value, operative methods, advantage and disadvantage of laparoscopic hernia sac high ligation in the treatment of pediatric inguinal hernia. Methods ： The clinical data of 843 cases laparoscopie hernia sac high ligation and 519 cases traditional open operation were comparatively analyzed. Operation time, hospital stay, intraoperative blood loss, the discov- ery of occult hernia, safety of anesthesia,postoperative complications and hospitalization costs of the 2 groups were observed. Results： All children were cured. Clinical data of laparoscopic group such as operation time, hospital stay,intraoperative blood loss, the discovery of occult hernia, safety of anesthesia, postoperative complications were significantly better than thoses of open group, while the hospitali- zation cost was a little higher. The differences were statistically significant （ P 〈 0.05 ）. 1 case （0.1% ） of recurrence was found in lap- aroseopic group, while 11 cases （2.1% ） were found in open group. Conclusions：Laparoscopic hernia sac high ligation has obvious ad- vantages such as simple operation, minimal trauma, quick recovery, safe anesthesia, few postoperative complications and so on. Contralat- eral occult hernia and bilateral hernia can be found and treated timely during the operation.