两种微创手术治疗小儿腹股沟斜疝的对比

Comparison of Two Kinds of Minimally Invasive Operations for the Treatment of Children with Indirect Inguinal Hernia

目的对采用两种微创手术治疗小儿腹股沟斜疝的临床疗效进行对比。方法回顾性分析该院于2013年1月—2014年3月收治的采用两种微创手术进行治疗的小儿腹股沟斜疝患者90例的临床资料,并随机分为两组,即下腹横纹小切口疝囊高位结扎术(开放手术组)40例,腹腔镜疝囊高位结扎术(腹腔镜组)50例,对比两组患者的手术时间、住院时间、住院费用、并发症、复发率。结果开放手术组手术时间(40.1±4.2)min,住院时间(4.2±0.7)d,住院费用(3280.64±40.21)元,无并发症,无一例复发;腹腔镜组手术时间(40.0±3.1)min,住院时间(4.1±0.2)d,住院费用(5431.25±46.58)元,无并发症,且无一例复发。开放手术组住院费用明显少于腹腔镜组,差异有统计学意义(P<0.05),而两组手术时间、住院时间、并发症方面差异无统计学意义(P>0.05)。结论下腹横纹小切口疝囊高位结扎术比腹腔镜手术更值得在基层医院推荐。

Objective To compare the clinical curative effect of two kinds of minimally invasive operations in the treatment of indi-rect inguinal hernia in children admitted in our hospital. Methods A retrospective analysis was conducted on the clinical data of 90 children with indirect inguinal hernia admitted in our hospital from January 2013 to March 2014. The children were randomly divided into two groups, and treated by two kinds of minimally invasive operations. 40 children （open surgery group） were treated by high ligation of hernial sac via small lower abdominal transverse incision, and 50 children （laparoscopy group） were treated by laparoscopic high ligation of hernial sac. And the duration of operation, length of stay, cost of hospitalization, complications, recur-rence rate of the two groups were compared. Results In the open surgery group, the duration of operation was （40.1 ±4.2） min, length of stay was （4.2±0.7） days, cost of hospitalization was （3280.64±40.21） yuan, no patients had complications and recurrence. In the laparoscopy group, the duration of operation was （40.0±3.1） min, length of stay was （4.1±0.2） days, cost of hospitalization was （5431.25±46.58） yuan, no patients had complications and recurrence. The cost of hospitalization of the open surgery group was much less than that of the laparoscopy group, the difference between the two groups was statistically significant, P〈0.05, while the differences in duration of operation, length of stay and complications between the groups were not statistically significant, P〉0.05. Conclusion High ligation of hernial sac via small lower abdominal transverse incision is worthy to be recommended in the basic hospital instead of laparoscopic operation.