单孔腹腔镜与传统开放手术治疗小儿腹股沟嵌顿疝对比分析

Comparative Analysis Between Single-port Laparoscopic Surgery and Traditional Operation for Incarcerated Inguinal Hernia in Children

目的比较单孔腹腔镜与传统开放手术治疗小儿腹股沟嵌顿疝的临床效果。方法选取我院2014年12月~2015年12月44例小儿腹股沟嵌顿疝,分成腔镜组和开放组,每组22例患儿,比较2组患儿手术时间、术中出血量、术后排气时间、术后住院时间及切口美观满意度评分。结果 44例手术顺利完成。与开放组相比,腔镜组手术时间明显缩短[(17.8±4.7)min vs.(30.6±8.2)min,t=-6.352,P=0.000],出血量明显减少[(4.8±1.3)ml vs.(10.6±3.2)ml,t=-7.876,P=0.000],术后排气时间明显缩短[(20.3±5.6)h vs.(26.4±7.9)h,t=-2.955,P=0.005],术后住院时间明显缩短[(2.8±0.7)d vs.(4.2±0.9)d,t=-5.759,P=0.000],切口美观满意度评分明显升高[(4.1±0.9)分vs.(3.0±0.8)分,t=4.285,P=0.000]。44例随访(10.6±4.3)月,全部患儿无复发及睾丸或卵巢萎缩。结论单孔腹腔镜手术治疗小儿腹股沟嵌顿疝安全可行,手术时间短,创伤小,恢复快,并能达到更好的美容效果,值得临床推广。

Objective To compare the clinical efficacy between single-port laparoscopic surgery and traditional operation in the treatment of incarcerated inguinal hernia in children. Methods From December 2014 to December 2015,44 children with incarcerated inguinal hernia were selected. They were divided into either laparoscopic surgery group or open surgery group,with 22 children in each group. The operation time, blood loss, postoperative exhaust time, postoperative hospital stay and aesthetic satisfaction score were compared between the two groups. Results All the 44 children were operated successfully. As compared with the open surgery group,the laparoscopic surgery group had shorter operation time [（17. 8 ± 4. 7） min vs.（30. 6 ± 8. 2） min,t =-6. 352,P = 0. 000 ],less blood loss [（4. 8 ± 1. 3） ml vs.（10. 6 ± 3. 2） ml,t =-7. 876,P = 0. 000 ],shorter postoperative exhaust time [（20. 3 ± 5. 6） h vs.（26. 4 ± 7. 9） h,t =-2. 955,P = 0. 005],and shorter postoperative hospital stay [（2. 8 ± 0. 7）d vs.（4. 2 ± 0. 9） d,t =-5. 759,P = 0. 000]. The aesthetic satisfaction scores was higher in the laparoscopic surgery group than that in the open surgery group [（4. 1 ± 0. 9） points vs.（3. 0 ± 0. 8） points,t = 4. 285,P = 0. 000]. The follow-up time was（10. 6 ±4. 3） months in the 44 children. There was no recurrence or atrophy of testis or ovaries. Conclusion The single-port laparoscopic surgery is safe and feasible for incarcerated inguinal hernia in children,with shorter operation time,minimal invasion,faster recovery,and better cosmetic outcomes. It is worthy of further clinical application.