腹腔镜经皮腹膜外手术治疗学龄前男性儿童腹股沟斜疝的临床分析

Clinical analysis of percutaneous extraperitoneal laparoscopic surgery for inguinal indirect hernia in male preschool children

目的：探讨腹腔镜下经皮腹膜外治疗学龄前男性儿童腹股沟斜疝的临床优越性。方法：分析2013~2014年收治的84例男性儿童腹股沟斜疝患儿的临床资料,41例行腹腔镜经皮腹膜外手术（观察组）,43例采用传统腹横纹小切口治疗（对照组）,手术均由同一组医师完成。对比分析两组患儿手术时间、术中出血量、住院时间、术后并发症等指标。结果：两组患儿均顺利完成手术,观察组手术时间[（17.35±2.11）min vs.（21.45±3.74）min]、术中出血量[（5.5±2.5）ml vs.（10.5±3.5）ml]、住院时间[（2.3±1.0）d vs.（3.3±1.8）d]优于对照组,差异有统计学意义（P〈0.05）。术后随访6个月,观察组单侧腹股沟斜疝患儿中1例对侧发生新发疝;对照组7例患儿出现对侧新发疝,两组均无复发疝。结论：腹腔镜下经皮腹膜外治疗学龄前男性儿童腹股沟斜疝是可行的,手术操作简便,住院时间短,术后并发症少,值得临床推广。

Objective： To discuss the clinical superiority of percutaneous extraperitoneal laparoscopic surgery for inguinal indirect hernia in male preschool children. Methods： The clinical data of 84 male preschool children who suffered from inguinal indirect hernia between 2013 and 2014 were analyzed,41 cases adopted percutaneous extraperitoneal laparoscopic treatment（ study group）,43 cases used the traditional small abdominal transverse incision（ control group）,the surgeries were performed by the same group of surgeons. Operative time,blood loss,the average postoperative hospital stay,postoperative complications of two groups were compared. Results： All operations were successful. In study group,the operative time [（ 17. 35 ± 2. 11） min vs.（ 21. 45 ± 3. 74） min],blood loss[（ 5. 5 ± 2. 5） ml vs.（ 10. 5 ± 3. 5） ml],hospital stay [（ 2. 3 ± 1. 0） d vs.（ 3. 3 ± 1. 8） d]were superior to those in the control group with statistical significance（ P〈0. 05）. Patients were followed up for 6 months. In study group,one contralateral new hernia occurred in child with unilateral inguinal hernia. Seven cases in the control group suffered from new-onset contralateral hernia. No hernia recurrence was found in both groups. Conclusions： Laparoscopic percutaneous extraperitoneal treatment of inguinal indirect hernia in preschool male children is feasible with simple surgical procedure,short hospital stay and few postoperative complications. This procedure is worthy of promotion.