小横切口高位结扎治疗小儿腹股沟斜疝66例体会

Experience of high ligation through small transverse incision in the treatment of 66 cases of indirect inguinal hernia in children

目的分析小横切口高位结扎治疗小儿腹股沟斜疝临床应用价值,总结手术经验。方法 2015年1月-2017年12月医院基础外科采用小横切口高位结扎治疗小儿腹股沟斜疝66例,纳入小切口组,选择同期采用传统开放手术处理的对象46例纳入对照组。对比2组手术时间、术中出血量、监护时间、住院时间,并发症发生情况、复发情况。结果小切口组手术时间、监护时间、住院时间均短于对照组(P <0. 01);小切口组切口延迟愈合、持续疼痛、阴囊水肿/肿胀发生率低于对照组(P <0. 01); 2组均未见医源性隐睾以及睾丸萎缩。结论小横切口高位结扎治疗小儿腹股沟斜疝有微创优势,但是对侧新发、复发率仍较高,需要重视术中解剖、术中诊断,规范处理。

Objective To analyze the clinical application value of high ligation through small transverse incision in the treatment of indirect inguinal hernia in children and summarize the experience of operation. Methods From January 2015 to December 2017,66 children with indirect inguinal hernia who underwent high ligation of small transverse incision were selected as the small incision group,and 46 children who underwent traditional operation at the same time were selected as the control group. The operation time,intraoperative bleeding volume,monitoring time,hospitalization time,complications and recurrence were compared between the two groups. Results The operation time,monitoring time and hospitalization time of small incision group were shorter than those of control group (P <0. 01). The incidence of delayed wound healing,persistent pain,scrotal edema or swelling in the small incision group was lower than that in the control group (P <0. 01). There was no iatrogenic cryptorchidism or testicular atrophy in both groups. Conclusion Small transverse incision high ligation minimally invasive surgery has obvious advantages in the treatment of indirect inguinal hernia in children,but the new incidence of the contralateral side of the method and the recurrence rate of the affected side are still high. It is necessary to pay attention to the identification of anatomical structure,intraoperative diagnosis and standardized treatment.