单孔法腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝的疗效分析

Analysis of efficacy of single-port laparoscopic high ligation of hernia sac in children with indirect inguinal hernia

目的探讨单孔法腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝的疗效。方法108例小儿腹股沟斜疝患儿,根据手术方法不同分为单孔组(46例)和二孔组(62例)。二孔组患儿行二孔法腹腔镜疝囊高位结扎术,单孔组患儿行单孔法腹腔镜疝囊高位结扎术。比较两组手术时间、切口长度、术后下床时间、术后24 h疼痛评分、阴囊水肿发生情况及复发情况。结果所有患儿均顺利完成手术。单孔组患儿手术时间(26.2±9.6)min、切口长度(6.5±0.6)mm、术后下床时间(4.2±1.2)h均显著短于二孔组(30.5±10.0)min、(10.8±2.1)mm、(6.8±1.3)h,术后24 h疼痛评分(1.6±0.7)分显著低于二孔组的(2.5±1.0)分,差异具有统计学意义(P<0.05)。单孔组35例男性患儿中发生1例阴囊水肿,发生率为2.86%(1/35);二孔组53例男性患儿中发生7例阴囊水肿,发生率为13.21%(7/53);两组男性患儿阴囊水肿发生率比较差异无统计学意义(χ2=2.733,P>0.05)。随访发现,单孔组出现1例疝复发,二孔组出现2例疝复发,两组疝复发率比较差异无统计学意义(χ2=0.108,P>0.05)。结论与二孔法相比,单孔法腹腔镜疝囊高位结扎术的手术时间短、手术切口小,患儿术后恢复快、疼痛感轻,值得临床推广。

Objective To discuss the efficacy of single-port laparoscopic high ligation of hernia sac in children with indirect inguinal hernia.Methods A total of 108 children with indirect inguinal hernia were divided into single-port group(46 cases)and double-port group(62 cases)according to different surgical methods.Children in the double-port group underwent double-port laparoscopic high ligation of hernia sac,while children in the single-port group underwent single-port laparoscopic high ligation of hernia sac.The operation time,incision length,postoperative off-bed activity time,pain score at 24 h postoperatively,occurrence and recurrence of scrotal edema were compared between the two groups.Results All children successfully completed the operation.The operation time(26.2±9.6)min,incision length(6.5±0.6)mm,and postoperative off-bed activity time(4.2±1.2)h of children in the single-port group were significantly shorter than(30.5±10.0)min,(10.8±2.1)mm and(6.8±1.3)h in the double-port group,and the pain score(1.6±0.7)points at 24 h postoperatively was significantly lower than(2.5±1.0)points of the double-port group.All the difference was statistically significant(P<0.05).1 case of scrotal edema occurred in 35 male children in the single-port group,with an incidence of 2.86%(1/35);7 cases of scrotal edema occurred in 53 male children in the double-port group,with an incidence of 13.21%(7/53).The difference in the incidence of scrotal edema among male children in the two groups was not statistically significant(χ2=2.733,P>0.05).Follow-up revealed 1 hernia recurrence in the single-port group and 2 hernia recurrences in the double-port group,and the difference in the hernia recurrence rate between the two groups was not statistically significant(χ2=0.108,P>0.05).Conclusion Compared with double-port laparoscopic high ligation of hernia sac,single-port laparoscopic high ligation of hernia sac has shorter operation time,smaller surgical incision,quicker postoperative recovery and less pain in children,and is worthy of clinical promotion.