腹腔镜下体外疝囊高位结扎术治疗小儿斜疝的疗效

Therapeutic effect of laparoscopic percutaneous extraperitoneal closure against indirect hernia of children

目的探讨硬膜外穿刺针联合双孔腹腔镜体外疝囊高位结扎法治疗小儿腹股沟疝的疗效。方法我院2015-01至2017-12共收治腹股沟斜疝患儿217例,按手术方式不同,分为腹腔镜手术组(观察组)和传统开放手术组(对照组),分析比较两组手术时间、住院时间、术后并发症等。结果观察组35. 9%的患儿术中发现合并对侧隐匿疝。两组在手术时间、切口感染、医源性隐睾发生率方面比较差异无统计学意义,在住院时间(2. 3±0. 1 vs 2. 6±0. 1,P=0. 002)、阴囊水肿发生率(0 vs 2. 8%,P=0. 045)及总并发症发生率(0 vs 4. 2%,P=0. 014)方面显著低于对照组,差异有统计学意义。结论此方法无需特制手术器械,不破坏腹股沟区组织解剖结构,手术安全、创伤小、并发症少、复发率低。

Objective To investigate the therapeutic effects of double-port laparoscopic percutaneous extraperitoneal closure using epidural puncture needles for indirect inguinal hernia in children. Methods Between January 2015 and December 2017 , 217 children with indirect inguinal hernia were treated. According to the surgical methods, these patients were divided into the laparoscopic group (observation group, 146 children) and the traditional open group ( control group, 71 children). Results Contralateral occult indirect inguinal hernias were found in 35. 9% of the children in obsenation group. There was no significant difference in the duration of surgery, incision infections or iatrogenic cryptorchidism between the two groups, but there was significant difference in the length of hospital stay(2. 3 ±0. 1 rs 2. 6 ±0. 1 , P =0. 002), scrotal edema (0 vs 2. 8%, P =0. 045 ) and total complications (0 ws 4. 2%, P = 0. 014) between the two groups. Conclusions This method is safe, simple, easy to learn, less traumatic, with fewer complications and a low recurrence rate. It is a better method for minimally invasive surgery of inguinal hernia in children, and is worthy of clinical application.