两种单孔式腹腔镜下疝囊高位结扎术在小儿腹股沟斜疝中的疗效对比

Clinical efficacy of two types of single-hole laparoscopic hernia sac high-ligation for pediatric inguinal hernia

目的对比两种经脐单孔腹腔镜下疝囊高位结扎术式在小儿腹股沟斜疝中的治疗效果。方法以2012年8月至2015年11月广东医科大学附属第三医院收治的92例小儿腹股沟斜疝患者为研究对象,按照接受术式的不同对病例进行分组,其中传统式单孔组(传统组) 44例,改良式复孔组(改良组) 48例,比较两组患儿的手术时间、住院时间及术后并发症情况。结果传统组住院时间、阴囊气肿发生率、术后切口感染发生率及术后复发率与改良组之间差异无统计学意义(P> 0. 05);但传统组比改良组手术耗时更长、术后阴囊血肿发生率更高(P <0. 05)。结论两种手术方式均为治疗小儿腹股沟斜疝安全有效的方法,但改良式单孔法具有手术时间更短、术后阴囊血肿发生率更低的优势,值得临床推广。

Objective To evaluate the clinical efficacy of two different clinical procedures of single-hole laparoscopic hernia sac high-ligation for pediatric inguinal hernia.Methods From August 2012 to November 2015,92 children with pediatric inguinal hernia fulfilling the standard criteria were randomly categorized into two groups using a simple random grouping method.The first group underwent traditional single-hole laparoscopic hernia sac high-ligation(n=44)while the second group improved single-hole laparoscopic hernia sac high-ligation(n=48).Operative duration,hospitalization stay and postoperative complications were compared between two procedures.Results No inter-group statistical differences existed in hospitalization duration,incidence of scrotal emphysema,incidence of postoperative incisional infection or postoperative recurrence rate(P >0.05).However,operative duration was significantly longer and the postoperative incidence of scrotal hematoma was higher in traditional group than that in modified group.The differences were statistically significant(P<0.05).Conclusion Both procedures are safe and effective for pediatric inguinal hernia in children.However,modified single-hole method is less time-consuming with a lower postoperative incidence of scrotal hematoma.It is worthy of a wider popularization.