腹腔镜下内环口不同进针点行疝囊高位结扎术治疗小儿巨大腹股沟斜疝的效果观察

Effect of laparoscopic high ligation of hernial sac at different entry points of internal ring in the treatment of giant indirect inguinal hernia in children

目的观察腹腔镜下内环口不同进针点行疝囊高位结扎术治疗小儿巨大腹股沟斜疝的效果。方法小儿巨大腹股沟斜疝400例分为对照组和实验组,每组200例。对照组在腹腔镜下内环口同一进针点行单纯高位结扎术,实验组在腹腔镜下内环口不同进针点行疝囊高位结扎术。术后1年内复查彩超提示腹股沟区可见肠内容物判为复发,比较两组的术后复发率。结果对照组复发8例,实验组复发1例,实验组的复发率低于对照组(P<0.05)。结论腹腔镜下内环口不同进针点行疝囊高位结扎术将疝囊缝合于内环口前壁肌肉,增强疝囊对抗腹腔压力,同时可使腹膜形成斜幕状达到增强结扎部位对抗腹腔内容物及腹腔压力,可降低术后复发率。

Objective To observe the effect of laparoscopic high ligation of hernial sac at different entry points of internal ring in the treatment of giant indirect inguinal hernia in children.Methods A total of 400 children with giant indirect inguinal hernia were divided into the Control Group and the experimental group,200 cases in each group.The Control Group underwent laparoscopic high ligation at the same entry point of the internal ring while the Experimental Group underwent laparoscopic high ligation at different entry points of the internal ring.If the color Doppler ultrasound shows the intestinal contents in the groin area at 1 a after operation,it is determined as relapse.The postoperative relapse rates of the two groups were compared.Results There were 8 relapse cases in the Control Group and 1 relapse case in the Experimental Group,and the relapse rate in the Experimental Group was lower than that in the Control Group(P<0.05).Conclusion Laparoscopic high ligation of hernia sac at different entry points sutures the hernial sac to the muscle of the anterior wall of the internal ring,which can enhance the resistance of the hernial sac against abdominal pressure and also make the peritoneum form oblique curtain to enhance the resistance of ligation site against abdominal contents and abdominal pressure,thus reducing the postoperative relapse rate.