改良完全腹膜外经脐单孔腹腔镜小儿腹股沟疝的疗效分析

Analysis of the Effect of Modified Complete Extraperitoneal Transumbilical Single-hole Laparoscopic Pediatric Inguinal Hernia

目的改良完全腹膜外经脐单孔腹腔镜下小儿腹股沟疝结扎术的疗效分析。方法于2017年1月-2019年8月,以随机数字表法随机选取该院腹股沟疝患儿120例入组,取其中60例作单钩疝针穿过腹膜进入腹腔组(以下简称"单钩组"),执行单孔腹腔镜下经皮穿刺单钩疝针腹腔内钩线结扎术(以下简称"单钩结扎术");另60例作双钩疝针未穿过完全在腹膜外勾线组(以下简称"双钩组"),组内患儿执行单孔腹腔镜下经皮改良穿刺改良双钩疝针未穿入腹腔完全腹膜外结扎术(以下简称"双钩结扎术")。比较两组患儿观察指标差异。结果双钩组手术耗时、术中出血量、住院时长、术后并发症率、复发率均低于单钩组,但差异无统计学意义(t=1.509、1.947、0.225,χ^2=3.135、0.565,P>0.05);而双钩组治疗满意度(98.33%)高于单钩组(78.33%),且各组治疗后较之治疗前VAS评分有改善,差异有统计学意义(χ^2=19.402,t=16.790、17.103,P<0.05)。结论应用改良完全腹膜外双钩疝针结扎术治疗小儿腹股沟疝为安全有效的治疗方式。

Objective To analyze the effect of modified total extraperitoneal single incision laparoscopic surgery in inguinal hernia children.Methods 120 inguinal hernia children treated from January 2017 to August 2019 in our hospital were conveniently selected and randomly assigned to two groups,60 cases in each group.The single-hooked hernia needle was punctured into peritoneum(hereinafter referred to as"single-hooked group")for laparoscopic ligation;the double-hooked needle was not completely punctured into peritoneum(hereinafter referred to as"double-hooked group")for modified total extraperitoneal single incision laparoscopic surgery.The perioperative indicatorswere compared.Results Compared with single-hooked group,the operation time,intraoperative blood loss,hospital stays,postoperative complication rate and recurrence rate in double-hooked group was slightly reduced,the difference was not statistically significant(t=1.509,1.947,0.225,χ^2=3.135,0.565,P>0.05);the treatment satisfaction in double-hooked group(98.33%)was higher than that of singlehooked group(78.33%);VAS(visual analogue scale)scores for two groups were remarkably improved,the difference was statistically significant(χ^2=19.402,t=16.790,17.103,P<0.05).Conclusion The modified total extraperitoneal single incision laparoscopic surgery is clinically proven to be effective.