腹腔镜细注射针头套线法治疗小儿鞘膜积液的临床疗效

Efficacy of pediatric hydrocele treated with laparoscopic sharp syringe needle with stitch

目的探讨腹腔镜下应用细注射针头套线法行内环口高位结扎术治疗小儿鞘膜积液的临床价值。方法对180例小儿鞘膜积液行手术治疗，在脐部正中、脐水平腹直肌旁置入5、3mmtrocar各一个，在腹腔镜直视下应用10号细注射针头套线经皮穿刺到腹膜与腹横肌间隙，完全于腹膜外高位环绕结扎内环口。随访1～10月，平均6月，观察手术时间、术后疼痛、临床疗效、复发率、并发症等发生情况。结果手术时间单侧7～10rain，平均8．0min；双侧12～15min，平均13．0min。患儿术后无明显疼痛，无阴囊水肿或血肿，无腹腔内出血等并发症。术后1d出院。随访1～10月，180例鞘膜积液全部治愈，无复发。腹壁、脐部切口未见明显疤痕。结论腹腔镜下细注射针头套线法治疗d,JL鞘膜积液，具有手术时间短、创伤小、并发症少、外形美观、治愈率高的特点，是治疗小儿鞘膜积液的良好方法，值得推广应用。

Objective To assess the efficacy of sharp syringe needle with stitch in laparoendoscopic surgery for pediatric hydrocele. Methods Surgery was performed for 180 cases of pediatric hydrocele. The 5mm and 3mm trocars were inserted through navel and rectus side. A 10c sharp syringe needle was penetrated percutaneously, and then advanced into the preperito- neal space of the PPV to obliterate the internal ring defect. All cases were followed up for ] month to 10 months （averaging 6 months）. Results The operation time was 7 to 10 minutes in one side （averaging 8 minutes） and 12 to 15 minutes in both sides （averaging 12 minutes）. The post-operative hospitalization time was 1 day. No serious pain happened. All children recov- ered well. No complications and recurrences occurred, and no obvious scar was found in the operative areas. Conclusions The sharp syringe needle with stitch in laparoendoscopic surgery for pediatric hydrocele has the advantages of short operation time, few complication, good efficacy and no obvious scar, which should be recommended in pediatric surgery.