7号针头联合针孔腹腔镜行单孔手术治疗小儿斜疝的体会(附50例报告)

The experience of single-port laparoscopic treatment of children’s indirect inguinal hernia using 7-gauge needle combined with pinhole laparoscope:with a report of 50 cases

目的:探讨应用7号针头(10 mL针管的针头)联合针孔腹腔镜行单孔小儿斜疝疝囊高位结扎术治疗小儿腹股沟斜疝的临床价值。方法:随机抽取2017年6月至2018年9月收治的100例腹股沟斜疝患儿作为研究对象,按手术方式分为针孔组(行单孔针孔腹腔镜手术,n=50)与开放组(行传统开放疝囊高位结扎术,n=50),比较两组相关临床指标。结果:针孔组手术时间、术后住院时间优于开放组,但增加了医疗费用(P<0.05);针孔组术后未发生阴囊水肿、切口脂肪液化,发生线结反应1例;开放组术后发生阴囊水肿4例、脂肪液化1例、线结反应4例;两组并发症发生率差异有统计学意义(P<0.05)。术后随访3~12个月,两组均无复发病例。结论:7号针头联合针孔腹腔镜行单孔疝囊高位结扎术治疗小儿腹股沟斜疝创伤小,康复快,手术时间及住院时间短,操作简单,学习曲线短,手术安全,效果明确,可同时发现并处理隐匿疝,并发症少,复发率低,值得临床推广。

Objective:To investigate the value of the 7-gauge needle(the needle of 10 mL needle tube)combined with pinhole laparoscopic single-port hernial sac high ligation in the treatment of pediatric indirect inguinal hernia.Methods:One hundred children with indirect inguinal hernia from Jun.2017 to Sep.2018 were randomly selected as research objects.They were divided into pinhole group(single-port pinhole laparoscopy,n=50)and open group(traditional open hernial sac high ligation,n=50)according to surgical methods,the clinical indicators of the two groups were compared.Results:Pinhole group was better than open group in operation time and postoperative hospital stay,but the hospitalization cost increased,the differences were statistically significant(P<0.05).There was no scrotal edema or incision fat liquefaction in the pinhole group,but 1 case of postoperative knotting reaction.Postoperative complications in the open group included 4 cases of scrotal edema,1 case of incision fat liquefaction and 4 cases of postoperative knotting reaction.The difference of complication rate between the two groups was statistically significant(P<0.05).There were no recurrence cases in the two groups during the follow-up period of 3-12 months.Conclusions:The 7-gauge needle combined with pinhole laparoscopic single-port hernia sac high ligation in the treatment of pediatric indirect inguinal hernia is safe and effective,has advantages of few trauma,quick recovery,short operation time and hospital stay,easy operation,short learning curve,fewer complications and low recurrence rate,the concealed hernia can be found and treated at the same time.This procedure is worthy of clinical promotion.