腹腔镜手术分类治疗儿童腹股沟斜疝

Laparoscopic Individualized Surgery in Treatment of Pediatric Indirect Inguinal Hernia

目的探讨腹腔镜手术分类治疗儿童腹股沟斜疝的安全性及临床效果。方法选取135例腹股沟斜疝患儿分为腹腔镜组85例和开放组50例,对比分析2组患儿手术时间、出血量、术后24 h疼痛评分及侧隐性疝、术区肿胀、3年复发等8项临床指标。结果(1)腹腔镜组与开放组手术时间分别为(20.8±9.8)、(24.4±5.6)min,出血量分别为(2.9±1.5)、(6.2±2.2)mL,术后24 h疼痛评分分别为(1.5±0.4)、(3.7±0.5)分,住院时间分别为(3.0±1.1)、(4.5±1.3)d,组间比较差异有统计学意义(P<0.05);(2)腹腔镜组与开放组发现对侧隐性疝例数分别为10(11.8%)、0(0.0%)例,术区肿胀分别为1(1.2%)、6(12.0%)例,组间比较差异有统计学意义(P<0.05);3年复发分别为5(5.9%)、3(6.0%)例,2组中男性儿童3年均未发生缺血性睾丸炎或睾丸萎缩,组间差异无统计学意义(P>0.05)。结论根据儿童年龄及疝囊颈大小分别采取相应的腹腔镜手术方式,技术上安全、可行,术后复发率与开放手术相当。

Objective To evaluate the safety and clinical efficacy of laparoscopic individualized surgery in the treatment of pediatric indirect inguinal hernia.Methods A total of 135 cases of pediatric indirect inguinal hernia were divided into laparoscopic group(n=85)and open group(n=50).Eight clinical indexes between the two groups were contrastively analyzed.Results(1)Four indexes of measurement data:the time of operation,intraoperative blood loss,pain score at 24 h after return to ward by numerical rating scale(NRS),and hospitalization time,were(20.8±9.8)min,(2.9±1.5)mL,(1.5±0.4)scores,(3.0±1.1)d in laparoscopic group and(24.4±5.6)min,(6.2±2.2)mL,(3.7±0.5)scores,(4.5±1.3)d in open group,respectively.The difference between the two groups were statistically significant(P<0.05).(2)Four indexes of enumeration data:contralateral occult hernia found at the time of operation,cases of swelling in surgical area were 10(11.8%),1(1.2%)in laparoscopic group and 0,6(12.0%)in open group,respectively.The difference between the two groups were statistically significant(P<0.05).3-year recurrence and 3-year ischemic orchitis or testicular atrophy were 5(5.9%),0 in laparoscopic group and 3(6.0%),0 in open group,respectively.There was no significant difference(P>0.05).Conclusion Laparoscopic individualized surgery according to age and hernia sac size in the treatment of pediatric indirect inguinal hernia is safe and feasible,with similar recurrence rates to the open surgery.