单孔腹腔镜完全腹膜外结扎法与传统开放手术对小儿腹股沟斜疝的疗效

Effect of laparoscopic single-port complete extraperitoneal ligation versus traditional open surgery in pediatric indirect inguinal hernia

目的探讨腹腔镜下单孔完全腹膜外结扎法与传统开放手术对小儿腹股沟斜疝的疗效。方法收集2018年2月至2021年10月安徽医科大学附属安庆医院收治的腹股沟斜疝男性患儿186例,按照手术方法分为A组与B组,每组患儿93例,A组采用传统开放手术方法治疗,B组采用单孔腹腔镜下完全腹膜外结扎法治疗。观察2组患儿围手术期情况、术后疼痛情况、并发症、患儿家属满意度以及术后复发率。结果B组手术时间、切口大小、术中出血量以及住院时间均显著小于A组(P<0.05);术后12、24、48 h B组疼痛量表评分显著低于A组(P<0.05);B组术后并发症发生率低于A组(P>0.05)、患儿家长满意率显著高于A组(P<0.05)、复发率低于A组(P>0.05)。结论单孔腹腔镜完全腹膜外结扎法治疗小儿腹股沟斜疝可减少患儿术中出血,手术时间短,患儿康复时间快,并且可以减轻患儿术后疼痛,并发症和斜疝复发率低。

Objective To investigate the effects of laparoscopic single-hole complete extraperitoneal ligation method and traditional open surgery on indirect inguinal hernia in pediatric patients.Methods A total of 186 male children with indirect inguinal hernia admitted to Anqing Hospital,Anhui Medical University from February 2018 to October 2021 were collected.Patients were divided into 93 cases in Group A and 93 cases in Group B according to surgical methods.Group A was treated by traditional open surgery and Group B was treated by laparoscopic single-hole complete extraperitoneal ligation.The perioperative conditions,postoperative pain,complications,satisfaction of the children's families and postoperative recurrence rate were observed in the two groups.Results The operation time,incision size,intraoperative bleeding and hospital stay were significantly lower in group B than in group A(P<0.05).The pain scores were significantly lower in group B than in group A at 12,24 and 48 h postoperatively(P<0.05).The incidence of postoperative complications was lower in group B than in group A,but the difference was not significant(P>0.05).The overall satisfaction rate of the child's family was significantly higher in group B than in group A(P<0.05).The recurrence rate in group B was lower than that in group A,but the difference was not significant(P>0.05).Conclusion The laparoscopic single-port complete extraperitoneal ligation method for the treatment of pediatric indirect inguinal hernia can reduce intraoperative bleeding,shorten the operation time,accelerate the recovery time,and can reduce postoperative pain in children,with low complication and low recurrence rate.