改良单孔腹腔镜内环口缝扎术治疗小儿鞘膜积液57例体会

Single-port Laparoscopic Treatment of Hydrocele in Children: A Report of 57 Cases

目的探讨改良单孔腹腔镜内环口缝扎术治疗小儿鞘膜积液的临床疗效。方法行改良单孔腹腔镜内环口缝扎术治疗小儿鞘膜积液57例，单侧50例，双侧7例。均在单孔腹腔镜下行改良内环口荷包缝合高位结扎术。结果单侧手术时间平均15（12—18）min，双侧手术时间平均25（22．28）min，术中发现隐匿性疝5例，均在直视下一并进行高位结扎术，找到输精管及精索血管并避开。术中无明显出血及血肿，无阴囊积气及其他副损伤，术后平均住院2d，切口以可吸收线缝合腹膜及皮下1针。术后平均随访12（6—24）个月，无复发，无切口及阴囊感染，无睾丸扭转、睾丸萎缩及发育异常等并发症发生。结论改良单孔腹腔镜内环口缝扎术治疗小儿鞘膜积液具有安全有效、创伤小、无瘢痕、康复快、住院时间短、操作简便、无需特殊器械等优点，值得基层医院推广。

Objective To explore a new method of single-port laparoscopy in the treatment of hydrocele in children. Methods 57 cases with the hydrocele were treated by single-port laparoscopic surgery in whom 30 cases on the fight lesion, 20 cases on the left lesion and 7 cases on the bilateral lesions. All patients underwent internal orifice high ligation with single-port laparoscopy, and the hydrocele of tunica vaginalis was drawn out. Results The average operative time was 10 - 15rain in unilateral hydrocele and 15 - 30min in bilateral hydrocele. The mean postoperative hospitalization was 2 days. Skin sutures were not required. All patients were followed up for 6 to 24months （mean 12 months）, and no complications nor recurrence occurred. Conclusions Single-port laparoscopic high ligation surgery is a simple, satisfactory, effective, and minimally invasive surgical method. It causes no infection of the wound, scrotum or testis, no nerve damage, nor pain or numb in lower abdomen.