腹腔镜单孔疝囊高位结扎术与传统小切口疝囊结扎术治疗小儿腹股沟斜疝的效果评价

Laparoscopic Single-Hole Hernia Sac High Ligation and Traditional Small-Incision Hernia Sac Ligation for Indirect Inguinal Hernia in Children

目的比较腹腔镜单孔疝囊高位结扎术与传统小切口疝囊结扎术治疗小儿腹股沟斜疝的效果。方法将70例小儿腹股沟斜疝患儿按照随机数字表法分为观察组和对照组各35例,观察组接受腹腔镜单孔疝囊高位结扎术治疗,对照组接受小切口疝囊高位结扎术治疗,比较2组患儿手术情况(单侧疝手术时间、双侧疝手术时间、术中出血量、术后下床时间及住院时间)、治疗总费用、术后并发症(切口感染、阴囊肿胀、线结反应、戳孔疝、疝囊积液/积气)以及随访6个月复发率。结果观察组患儿单侧疝手术时间、双侧疝手术时间、术中出血量、术后下床时间及住院时间均显著少于对照组,治疗总费用显著高于对照组(均P<0.05);观察组患儿术后并发症总发生率显著低于对照组(P<0.05),2组患儿术后复发率比较差异无统计学意义(P>0.05)。结论腹腔镜单孔疝囊高位结扎术治疗小儿腹股沟斜疝创伤小、术后恢复快、并发症少、复发率低,但治疗费用较高且对操作者要求较高,临床可根据实际情况进行选择。

Objective To compare the efficacies of laparoscopic single hole hernia sac high ligation and traditional small incision hernia sac ligation for pediatric indirect inguinal hernia.Methods Seventy children with indirect inguinal hernia were randomly assigned to receive either laparoscopic single hole hernia sac high ligation(observation group,n=35)or traditional small incision hernia sac ligation(control group,n=35).Operation situations(operation time for unilateral hernia,operation time for bilateral hernia,intraoperative blood loss,time to postoperative activity and length of hospital stay),total treatment cost,postoperative complications(incision infection,scrotal swelling,knotting reaction,trocar site hernia and hernia sac effusion/pneumatosis),and 6 month recurrence rate were compared between the two groups.Results Compared with control group,operation time for unilateral hernia,operation time for bilateral hernia,intraoperative blood loss,time to postoperative activity,length of hospital stay and incidence of postoperative complications were reduced,but total treatment cost was increased in observation group(P<0.05).There was no significant difference in postoperative recurrent rate between the two groups(P>0.05).Conclusion Single hole laparoscopic hernia sac high ligation for indirect inguinal hernia is associated with small trauma,fast recovery,few complications and low recurrence rate in children.However,it results in higher treatment cost and operator requirement.The treatment procedures can be chosen according to the actual situation.