腹壁缝合穿刺针辅助小儿腹腔镜睾丸下降固定术的临床疗效与优势评价

The efficacy and advantages of laparoscopic orchidopexy via abdominal wall suture needle in children

目的探讨腹壁缝合穿刺针辅助小儿腹腔镜睾丸下降固定术的临床疗效与优势。方法回顾性分析2016年4月至2019年1月本院收治的56例隐睾患儿的临床资料,其中29例采用腹壁缝合穿刺针辅助腹腔镜睾丸下降固定术(LOAWSN)治疗(穿刺针组),27例采用常规三孔腹腔镜睾丸引降固定术(TLO)治疗(三切孔组),比较两组手术时间、术中出血量、术后住院时间、术后睾丸发育情况等指标。结果两组患儿均治愈出院,术后随访6~12个月,穿刺针组的手术时间[(36.35±7.81)min]明显低于三切孔组的手术时间[(42.10±5.74)min],差异有统计学意义(t=9.030,P=0.000);两组术中出血量比较,差异无统计学意义[(4.38±2.94)mL vs.(4.96±3.75)mL,t=2.785,P=0.772];两组术后住院时间比较,差异无统计学意义[(5.89±0.48)d vs.(5.72±0.55)d,t=0.980,P=0.392];穿刺针组术后6~12个月复查B超显示术后睾丸发育良好、一般、较差的患者分别为22、4、1例,三切孔组分别为24、5、0例,两组差异无统计学意义(χ^2=1.109,P=0.860)。结论采用腹壁缝合穿刺针辅助腹腔镜睾丸下降固定术治疗小儿隐睾是一种安全有效的方法,手术时间短,术后瘢痕隐蔽、美观。

Objective To introduce the efficacy and advantage of laparoscopic orchidopexy via abdominal wall suture needle(LOAWSN)in children.Methods A retrospective analysis was conducted on 56 cases of children acute appendicitis cases in our hospital from April 2016 to January 2019,29 cases were treatment by LOAWSN group,27 cases were treatment by traditional three ports group.Surgical operation time,intraoperative blood loss,the length of hospital stay were compared.The ultrasound examination was performed after surgery in 6-12 months.Results Fifty-six cases were cured and discharged,the two groups were followed up for 6 to 12 months postoperatively.Operation time of LOAWSN group and three ports group were(36.35±7.81)min and(42.10±5.74)min,LOAWSN group was shorter than three ports group,and there were statistical significance(P<0.01),There were no significant statistically difference between the two groups in Intraoperative blood loss of LOAWSN group and three ports group were(4.38±2.94)mL and(4.96±3.75)mL,there were no statistical significance(t=2.785,P=0.772).The length of hospital stay of LOAWSN group and three ports group were(5.89±0.48)d and(5.72±0.55)d,there were no statistical significance(t=0.980,P=0.392).The ultrasound examination result after surgery in 6-12 months of LOAWSN group and three ports group were divided good,general and bad group,the number were(22/4/1)and(24/5/0).There were no statistical significance(χ^2=1.109,P=0.860).Conclusions Laparoscopic orchidopexy via abdominal wall suture needle(LOAWSN)in children cryptorchidism is a safe and effective method,operation time is much more shorter,postoperative scar is much more invisibly and beautiful.