小儿腹腔镜疝囊高位结扎术的临床疗效分析

The clinical curative effect analysis of laparoscopic hernia sac high ligation in children

目的：探讨腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝的临床应用价值。方法：回顾分析2001年6月至2014年6月为816例腹股沟斜疝患儿行腹腔镜疝囊高位结扎术的临床资料，其中男704例，女112例；10个月～12岁，平均（4．26±2．76）岁；右侧452例，左侧316例，双侧48例，隐性疝132例；均行全麻气管插管。结果：本组816例手术均顺利完成，无一例中转开腹，手术时间10—45min，单侧平均（20±4）min，双侧平均（25±6）min。术后平均住院（3．2±0．8）d。术后第2天开始正常进食。术后瘢痕极小，无精索及输精管损伤、皮下血肿、阴囊血肿、戳孔疝等并发症发生。810例获得随访，随访6—40个月，平均（12．5±4．5）个月，失访6例，复发2例。结论：腹腔镜小儿腹股沟斜疝疝囊高位结扎术具有创伤小、手术时间短、术后康复快、操作简单易学、复发率低、切口美观、可同时处理双侧疝等优点，术中可发现对侧隐性疝并同时处理，值得临养椎广矗嗣：

Objective ： To explore the clinical value of laparoscopic hernia sac high ligation in the treatment of pediatric indirect inguinal hernia. Methods ：A retrospective analysis was made on the clinical data of 816 children who suffered from indirect inguinal hernia and were treated with laparoscopic high ligation of hernia sac from Jun. 2001 to Jun. 2014, among which 704 were males, 112 were females, age ranged from 10 months to 12 years old, mean age was （4.26 _± 2.76 ） years ;452 cases were on the right side,316 ca- ses on the left ,48 cases on both sides, the occult hernia was found in 132 cases. General anesthesia and endotracheal intubation anesthe- sia were used in the operation. Results：All 816 operations were successfully performed without conversion to laparotomy. Operation time was 10-45 min, mean operating time was （20 ± 4） min for unilateral and （25 ± 6） min for bilateral inguinal hernia. The mean postoper- ative hospital stay was （3.2 ± 0.8 ） d. Two days after the surgery patients returned to normal diet. Postoperative scars were minimal and complications such as spermatic cord injury,injury of vas deferens, subcutaneous hematoma, scrota] hematoma, port-site hernia didn＇ t occur. 810 cases were followed up for 6 to 40 months,the average was （ 12.5 _±4.5） months,and 6 cases were lost. 2 recurrent cases were found. Conclusions： Laparoscopic pediatric high ligation of inguinal hernia sac has obvious advantages such as small surgical trau- ma ,short operation time, quick recovery, simple operation, low recurrence rate, beautiful incision, handling bilateral inguinal hernia, founding and treating contralateral occult hernia timely during the operation, is worth popularization and application in clinic.