经脐腹腔镜手术与传统手术治疗小儿高位隐睾的临床效果比较

The comparison of surgical indexes and complications between transumbilical laparoscopy and traditional surgery in the treatment of high cryptorchidism in children

目的比较经脐腹腔镜手术与传统手术治疗小儿高位隐睾的临床效果。方法回顾性分析2017年1月至2018年12月保定市妇幼保健院收治的120例高位隐睾患儿的临床资料。根据治疗方案不同将患儿分为经脐腹腔镜组(n=69)和传统组(n=51)。观察并比较两组的手术指标、术前及术后6个月睾丸容积、抗苗勒管激素(AMH)水平、抑制素B(INHB)水平,记录并比较两组术后6个月内的并发症发生率。结果经脐腹腔镜组的手术时间长于传统组,术中出血量少于传统组,住院时间短于传统组,差异具有统计学意义(P<0.05);两组Ⅰ期手术率比较,差异无统计学意义(P>0.05);两组术后6个月睾丸容积、AMH、INHB水平均高于术前,差异具有统计学意义(P<0.05);两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论经脐腹腔镜手术与传统手术均可增加高位隐睾患儿的睾丸容积,改善睾丸功能,然而与传统手术相比,经脐腹腔镜手术可进一步减少手术创伤,缩短患儿住院时间,同时还尽可能保证了睾丸无张力降入阴囊内,预防术后睾丸回缩。

Objective To investigate the surgical indexes and complication between transumbilical laparoscopy and traditional surgery in the treatment of high cryptorchidism in children.Methods The clinical data of 120 children with high cryptorchidism admitted to Baoding Maternal and Child Health Hospital from January 2017 to December 2018 were retrospectively analyzed.The children were divided into the transumbilical laparoscopic group(n=69)and the traditional group(n=51)according to different treatment plans.The surgical indicators,preoperative and postoperative testicular volume,anti-Müllerian hormone(AMH)and inhibin B(INHB)levels were observed and compared between the two groups,and the incidence of complications within 6 months after operation was recorded and compared between the two groups.Results Compared with the transumbilical laparoscopic group,the operation time was longer than the traditional group,the intraoperative blood loss was less than the traditional group,and the hospital stay was shorter than the traditional group,the differences were statistically significant(P<0.05).There was no significant difference in stageⅠoperation rate between the two groups(P>0.05).6 months after operation,testicular volume,AMH and INHB levels in two groups were higher than those before operation,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusions Both transumbilical laparoscopic surgery and traditional surgery can improve the testicular function of high cryptorchidism in children,but transumbilical laparoscopic surgery has more advantages in reducing surgical trauma and postoperative complications.