腹腔镜下治疗儿童巨大腹股沟斜疝86例

86 cases of pediatric patients with laparoscopic inguinal hernia

目的探讨腹腔镜下治疗儿童巨大腹股沟疝术式选择及临床效果。方法回顾性分析一汽总医院2009年6月至2011年8月采用腹腔镜术式治疗巨大儿童腹股沟疝86例,将86例患儿随机分为观察组(46例)和对照组(40例)。观察组采用腹腔镜下缝合髂耻束缩窄内环+内环口结扎术,对照组采用腹腔镜下内环口结扎术+脐内侧韧带覆盖内环口。比较二组患儿手术时间、术后疼痛、术后复发情况。结果所有患儿均顺利完成手术并随访2年,二组在手术时间和术后疼痛方面差异无统计学意义(t=0.536、0.624,P=0.468、0.532)。观察组术后无复发,对照组术后复发3例,二组复发率比较差异有统计学意义(χ2=3.575,P<0.05)。结论腹腔镜下缝合髂耻束缩窄内环+内环结扎术对比腹腔镜下脐内侧韧带覆盖内环口+内环结扎术可更好的预防儿童巨大腹股沟疝术后复发。

Objective To explore the treatment and clinical effect of laparoseopic operations in pediatric patients with inguinal hernia. Methods A total of 86 cases were retrospetively analyzed in the FAW General Hospital from June 2009 to August 2011. The patients with huge children inguinal hernia were radomly class/fed into an observation group （46 cases） and a control group （40 cases）. The observation group was treated with laparoscopic suture iliopubic tract constriction ring ＋ inner loop ligation. The control group was applied with lapamscopic internal ring ligation ＋ medial umbilical ligament covered with internal ring. The time of operation, pain after operation, and postoperative recurrence were compared. Results All patients successfully completed the operation and 2 years of follow-ups. No significant difference was observed in operation time and postoperative pain （ t = 0. 536, 0. 624, P = 0.468, 0.532）. No recurrence was found in the observation group. There were only 3 cases of recurrence after operation in control group. The rate difference between the groups was statistically significant （x2 = 3. 575, P 〈 0. 05）. Conclusions The laparoseopic suture iliopubic tract constriction ring ligation ＋ laparoseopie medial umbilical ligament eovered with the inner ring ligation can better prevent recurrence of children with inguinal hernia.