两种不同手术方式治疗腹股沟型隐睾的临床分析

Clinical analysis of two different surgical methods for treatment of inguinal cryptorchidism

目的分析比较腹腔镜手术与传统开放手术治疗小儿腹股沟型隐睾临床效果。方法回顾性分析郑州大学第一附属医院2015年1月-2018年1月收治的232例腹股沟型隐睾患儿,随机选择其中116例腹腔镜手术治疗的患儿作为观察组,开放手术治疗的116例患儿作为对照组。观察两组手术时间、术中出血量、术中及术后并发症、患儿术后疼痛程度,家属对手术外观满意度情况。结果两组患儿,均一期手术完成,观察组手术时间与对照组相比,差异不具有统计学意义(P>0.05);与对照组比较,观察组术中出血量较少,术后疼痛评分及术后并发症发生率较低,术后住院时间较短,差异均有统计学意义(P<0.05)。术后随访1-4年,对照组出现新发鞘膜积液3例、睾丸回缩5例,睾丸萎缩1例,观察组未出现睾丸回缩、萎缩、鞘膜积液等症状,两者相比差异具有统计学意义(P<0.05)。观察组家属对手术外观满意度高于对照组,两者比较差异均具有统计学意义(P<0.05)。结论腹腔镜治疗小儿腹股沟型隐睾安全可靠,可同时缝合双侧未闭鞘状突管,减少二次手术几率,临床效果优于传统开放手术,值得推广。

Objective Clinical analysis and comparison of laparoscopic surgery and traditional open surgery in the treatment of pediatric inguinal cryptorchidism.Methods A retrospective analysis of 232 cases of inguinal cryptorchidism admitted to our hospital from January 2015 to January 2018. 116 children who underwent laparoscopic surgery were randomly selected as observation group, and 116 other children who underwent open surgery were as a control group. The operation time, intraoperative blood loss, intraoperative and postoperative complications, postoperative pain degree of the children, and family members’ satisfaction with the appearance of the operation were observed. Results The 232 cases of the two groups were performed in the first stage. No significant between-group difference was found in the operation time(P>0.05). The intraoperative blood loss, postoperative complications and hospital stay in the observation group were all less than that of the control group, significant differences between two groups were observed(P<0.05). The patients were followed up for 1-4 years. In the control group, there were 3 cases of hydrocele, 5 cases of testicular retraction and 1 case of testicular atrophy. There was no testicular retraction,atrophy and hydrocele in the observation group(P<0.05). The average score of postoperative pain in the observation group was lower than that in the control group, and the family members were more satisfied with the appearance of the operation than that of the control group. which showed a significant between-group difference(P<0.05).Conclusion Laparoscopic treatment of pediatric inguinal cryptorchidism is safe and reliable. It can suture bilateral processus vaginalis at the same time, reducing the chance of secondary operation. The clinical effect is better than traditional open surgery and it is worthy of promotion.