腹腔镜治疗小儿腹股沟斜疝的临床疗效

Clinical effects of laparoscopic indirect inguinal hernia repair in children

目的探讨腹腔镜手术在小儿腹股沟斜疝(PIH)患儿中的临床疗效。方法选取2013年1月—2018年3月进行腹腔镜手术治疗的255例PIH患儿作为腹腔镜组,同期选取进行传统疝囊高位结扎术治疗的183例小儿PIH患儿作为对照组;比较两组患儿手术时间、术中出血量、术后活动恢复时间、住院时间、术后疼痛、术后并发症及半年内复发率。结果腹腔镜组手术时间[(19. 75±1. 24) min对(25. 16±1. 63) min]、术后恢复自主活动时间[(19. 12±2. 17) h对(28. 24±3. 46) h]及住院时间[(3. 21±0. 87) d对(5. 13±0. 95) d]均显著短于对照组(P <0. 05);且术中出血量[(3. 12±0. 64) mL对(10. 63±1. 71) mL,P <0. 05]、术后并发症发生率[(1. 18%对8. 20%,χ~2=13. 3244,P <0. 05)]、复发率[(0. 00%对2. 73%,χ~2=4. 8345,P <0. 05)]均显著低于对照组。结论腹腔镜手术治疗小儿腹股沟斜疝,微创,手术时间短,术后恢复快,并发症和复发率低,值得临床推广。

Objective To explore the clinical effects of laparoscopic indirect inguinal hernia repair in children. Methods A total of 255 patients with pediatric indirect inguinal hernia （PIH） who received laparoscopic indirect inguinal hernia repair （laparoscopic group） and 183 PIH children who received conventional operation （control group） from January 2013 to September 2018 were enrolled in the study. The operation time, blood loss volume during operation, ability recovery time, hospital stay time, postoperation pain, complication rate, and half-year recurrence rate were compared between the two groups. Results The operation time [ （ 19.75 ± 1.24） min vs. （ 25.16 ± 1.63 ） min ] , ability recovery time [（19.12 ±2.17） h vs. （28.24 ±3.46） h） ] , and hospital stay time [ （3.21 ±0.87） d vs. （5.13 ± 0.95 ） d] of the laparoscopic group were significantly shorter than those of the control group （ P 〈 0.05 ） ; the blood loss volume during operation [（3.12 ± 0.64） mL vs. （ 10.63 ± 1.71 ） mL] , complication rate （ 1.18% vs. 8.20% ; χ^2 = 13. 3244） ,and half-year recurrence rate （0.00% vs. 2.73% ; χ^2 = 4. 8345） of the laparoscopic group were also significantly lower than those of the control group （ P 〈 0, 05 ）. Conclusion Laparoscopic indirect inguinal hernia repair for PIH not only saves operation time, but also benefits patients＇ recovery, with less complications and recurrences, which deserves clinical promotion.