单孔腹腔镜疝高位结扎术在小儿隐匿疝治疗中的意义

Effect of single port laparoscopic hernia sac high ligation on pediatric occult hernia

目的 评价单孔腹腔镜在小儿隐匿疝诊断及治疗中的价值。方法 收集我院2008~2012收治的小儿腹股沟斜疝高位结扎术病例1864例,隐匿疝病例534例（28.6%）,隐匿疝病例中采用单孔腹腔镜手术436例（腔镜组）,传统开放手术98例（传统组）。通过隐匿疝的发现率,治疗总费用、住院天数及手术并发症统计和分析,评估腹腔镜诊治小儿隐匿疝的优势。结果 单孔腹腔镜手术组与传统开放手术组在小儿隐匿疝发现率、治疗总费用、住院天数和手术并发症等方面的比较有显著性差异（P〈0.05）。结论 单孔腹腔镜行小儿疝高位结扎术不但能同时发现术前漏诊的对侧隐匿疝,并可同时手术治疗,避免了患儿再次手术的痛苦,减少了经济负担,具有传统开放手术不可比拟的优点。

Objective To evaluate the effect of laparoscopic hernia sac high ligation on pediatric occult hernia. Methods 1864 high ligation surgeries on children occult hernia were operated in our hospital between 2008 and 2012. There were 534（28.6%） occult hernias. Of them, 436 cases were repaired with single port macroscopic surgery and 98 cases underwent traditional open surgery.The discovery rate, hospital stay, complications and the total cost of the two types of surgery were compared and analyzed. Results There were significant differences between single port macroscopic surgery and traditional open surgery in the discovery rate of occult hernia, total cost, hospital days and operative complication（P〈0.05）. Conclusion Single port laparoscopic sac high ligation operation has advantage over the traditional open surgery. It is suggestive the surgical approach would be adopted due to its advantage of finding contralateral occults hernia.