经脐单孔腹腔镜疝囊高位结扎术的治疗效果

Treatment effects of transumbilical single-site laparoscopic high ligation of hernia sac

目的:探讨经脐单孔腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝的临床效果及对术后并发症、复发率的影响。方法:将2010年6月至2015年6月行疝囊高位结扎的658例单侧腹股沟斜疝患儿分为腔镜组(n=476)与传统组(n=182),对比两组手术效果、并发症发生情况及随访3年复发率、对侧异时性疝发生率。结果:腔镜组手术时间、切口大小、术中出血量、住院时间、术后阴囊血肿、睾丸萎缩及并发症总体发生率均优于传统组,差异有统计学意义(P<0.05)。术后随访3年,腔镜组无对侧异时性疝发生,传统组对侧异时性疝发生率为2.75%,差异有统计学意义(P<0.05);两组术后复发率分别为0.42%与1.65%,差异无统计学意义(P>0.05)。结论:经脐单孔腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝效果良好,具有明显的微创优势,可减少术后并发症的发生,促进患儿快速康复,并能有效防止对侧异时性疝的发生。

Objective: To explore the clinical effects of transumbilical single-site laparoscopic high ligation of hernia sac in the treatment of pediatric indirect inguinal hernia (PIH) and its effects on postoperative complications and recurrence rate. Methods: The clinical data of 658 children with unilateral PIH who underwent hernia sac high ligation from Jun.2010 to Jun.2015 were analyzed,and the patients were divided into laparoscopic group ( n =476) and traditional group ( n =182).The surgical effects,occurrence of complications,recurrence rate during the follow-up of 3 years and incidence of metachronous contralateral hernia (MCH) were compared between the two groups. Results: The operative time,incision size,intraoperative blood loss,hospital stay,incidence of postoperative scrotal hematoma,testicular atrophy and the incidence of overall complications in laparoscopic group were less than those in traditional group ( P< 0.05).During follow-up of 3 years,there was no MCH in laparoscopic group,and the incidence of MCH was 2.75% in traditional group ( P< 0.05);the recurrence rate of PIH was 0.42% and 1.65% respectively ( P> 0.05). Conclusions: Transumbilical single-site laparoscopic high ligation of hernia sac has good effects on PIH.In addition to its obvious minimally invasive advantages,it can reduce postoperative complications,promote rapid recovery,and effectively prevent MCH.