单孔腹腔镜下应用硬膜外穿刺针治疗小儿腹股沟斜疝682例

Single-port mini-laparoscopic treatment with epidural needle for children with indirect hernia: A report of 682 cases

目的探讨经脐单孔腹腔镜下应用硬膜外穿刺针联合行疝囊高位结扎治疗小儿腹股沟斜疝的应用价值。方法回顾分析2016年2月至2018年7月,安徽阜阳疝病专科医院利用硬膜外穿刺针在单孔腹腔镜下治疗腹股沟疝682例患儿的临床疗效。结果682例患儿手术均在单孔腹腔镜下顺利完成,无精索血管或输精管损伤。手术时间:单侧5~12 min,平均8.5 min;双侧10~24 min,平均17 min。术中发现并同时处理对侧隐匿性斜疝75例(13.09%)。术中出血量为0.5~2 ml,平均1 ml。患儿麻醉完全清醒后恢复饮食,并可下床活动。所有患儿均在术后次日上午办理出院。术后及随访期间均未发现并发症及复发病例。结论应用硬膜外穿刺针行单孔法腹腔镜高位结扎疝囊治疗小儿斜疝初步结果显示安全有效,操作简便,而且具有创伤小,术后恢复快、不留瘢痕等优点,值得临床开展及推广应用。

Objective To discuss the clinical value of single-port mini-laparoscopic treatment with epidural needle for children with indirect hernia.Methods 682 cases of children with indirect inguinal hernia of Fuyang Hospital of Hernia Disease hospital between February 2016 and July 2018 were enrolled in this study.They were treated by high ligation of inguinal hernial sac under single-port mini-laparoscopic surgery with epidural needle and guided suture.To analyze the operation time,blood loss,postoperative complications and recurrence rate for all cases.The clinical data were retrospectively analyzed.Results All surgery was successfully completed.Operation time was 8.5 minutes(5 to 12 minutes)in 573 cases of unilateral hernia and 17 minutes(10 to 24 minutes)in 184 cases of bilateral hernia.Bleeding volume during the operation was 0.5 to 2 ml,mean of 1 ml.After a follow-up of 2 to 27 months,no complications and recurrence were presented.Conclusion The laparoscopic technique for pediatric indirect inguinal hernia with epidural needle is safe and reliable,with minor invasion and satisfied outcome.It is easy to be learned and performed,which is worth of being generalized.