经脐单一切口腹腔镜下手术对小儿隐睾症的临床疗效、疼痛评分及瘢痕美观度影响

Effects of Laparoscopic Surgery through an Umbilical Single Incision on Clinical Efficacy,Pain Score and Scar Appearance in Treatment of Children with Cryptorchidism

目的探讨经脐单一切口腹腔镜下手术对小儿隐睾症的临床疗效、疼痛评分及瘢痕美观度的影响。方法回顾性分析2018年1月—2019年12月在本院行腹腔镜辅助手术治疗的94例隐睾症患儿的临床资料,根据手术方式不同分为对照组50例和观察组44例。对照组行传统三孔腹腔镜手术,观察组行经脐单一切口腹腔镜手术。比较2组临床疗效、评估2组术后6、12、24 h的疼痛程度及相关临床指标、术后并发症发生情况、瘢痕美观度。结果2组治疗总有效率比较差异无统计学意义(P>0.05)。与对照组比较,观察组术中出血量减少,手术时间、住院时间缩短,下床活动时间明显更早,差异均有统计学意义(P<0.05)。观察组术后6 h的采用视觉模拟评分(VAS)及术后止痛药使用率明显低于对照组(P<0.05)。2组术后12、24 h的VAS评分及术后并发症总发生率比较差异无统计学意义(P>0.05)。观察组术后皮肤表面瘢痕长度显著短于对照组(P<0.05)。结论经脐单一切口腹腔镜下手术治疗对小儿隐睾症具有较高的临床疗效,相对于传统三孔腹腔镜手术,具有术中出血量少、手术时间短、住院时间短、术后疼痛感轻等优势,且患儿腹部瘢痕短,更为美观。

Objective To investigate effects of laparoscopic surgery through a umbilical single incision on clinical efficacy,pain score and scar appearance in treatment of children with cryptorchidism.Methods Clinical data of 94 children with cryptorchidism who underwent laparoscopic assisted surgery during January 2018 and December 2019 was retrospectively analyzed,and they were divided into control group(n=50)and observation group(n=44)according to different surgical methods.Control group was treated with traditional three ports laparoscopic surgery,while observation group was treated with laparoscopic surgery through an umbilical single incision.Clinical efficacy was compared in two groups.Visual analogue scale(VAS)was used to evaluate degrees of pain at the 6 th,12 th and 24 th h after operation,and values of clinical indicators,incidence rate of complications and scar appearance after operation were compared in two groups.Results There was no significant difference in the total effective rate between two groups(P>0.05).Compared with those in control group,values of intraoperative blood loss,operative time and hospitalization time were significantly shortened,and the time of getting out of bed was significantly earlier in observation group,and the differences were statistically significant(P<0.05).VAS score at the 6 th after operation and the use rate of postoperative analgesics in observation group were significantly lower than those in control group(P<0.05).There were no significant differences in VAS scores at the 12 th and 24 th h after operation and total incidence rate of postoperative complications between two groups(P>0.05).The scar length on surface of skin in observation group was significantly shorter than that in control group(P<0.05).Conclusion Laparoscopic surgery through a umbilical single incision may achieve better clinical efficacy in the treatment of children with cryptorchidism.Compared with those by traditional three ports laparoscopic surgery,it has the advantages such as less intraoperative blood loss,shorter operative time,hospitalization time,and time of postoperative pain.It also has shorter length of abdominal scars and more beautiful appearance.