腹腔镜术中不同打结方案治疗小儿腹股沟斜疝的对比研究

Comparative study of different laparoscopic knotting scheme in the treatment of children with indirect inguinal hernia

目的:探讨腹腔镜下体内与体外打结对小儿腹股沟斜疝术中、术后临床指标及术后并发症、复发风险的影响。方法:选取2015年1月至2016年12月收治的160例腹股沟斜疝患儿,以随机数字表法分为A组(n=80)与B组(n=80),腹腔镜下分别采用体内与体外打结法。比较两组患儿术中、术后临床指标、术后并发症及随访复发率。结果:B组手术时间短于A组(P<0.05),术后线结反应发生率高于A组(P<0.05);两组术中出血量、总住院时间、术后切口感染率、术后6个月、12个月复发率差异无统计学意义(P>0.05)。结论:腹腔镜下两种打结方案的医源性创伤程度、复发风险较为接近;其中体外打结可有效缩短手术时间,但术后线结反应发生风险更高。

Objective： To discuss the influence of laparoscopic knotting scheme in vivo and in vitro on the intraoperative and postoperative clinical indexes,the postoperative complications and recurrence risk of children with indirect inguinal hernia. Methods：One hundred and sixty children with indirect inguinal hernia were chosen in the period from Jan.2015 to Dec.2016 and randomly divided into control group（ n = 80） with in vivo knotting scheme and observation group（ n = 80） with in vitro knotting scheme by laparoscopic single site surgery; and the levels of intraoperative and postoperative clinical indexes,postoperative complications and recurrence risk of two groups were compared.Results： The operation time of observation group was significantly shorter than that of control group（ P〈0.05）.The postoperative nodal reaction incidence of observation group was significantly higher than that of control group（ P 0. 05）.There were no significant differences in the intraoperative bleeding volume,total hospitalization time,the incision infection incidence,the recurrence rate in 6 months and 12 months between the two groups（ P〈0.05）.Conclusions： The laparoscopic knotting schemes in vivo and in vitro in the treatment of children with indirect inguinal hernia possess the similar iatrogenic trauma and recurrence risk. In vitro knotting scheme can effectively reduce operation time but is associated with higher risk of knotting reaction.