腹腔镜囊壁部分切除联合内环口修复治疗小儿腹阴囊鞘膜积液12例临床应用

Clinical application of laparoscopic partial excision of the cyst wall combined with internal inguinal ring repair in the treatment of pediatric abdominoscrotal hydrocele in 12 cases

目的探讨腹腔镜囊壁部分切除联合内环口修复治疗小儿腹阴囊鞘膜积液(ASH)的可行性和安全性。方法回顾性分析2017年3月—2020年5月在郑州大学附属儿童医院接受治疗的12例ASH患儿的病历,对临床表现、术前诊断、术中所见、合并其他异常、术后结果进行总结。结果9例术前诊断为ASH,3例腹腔镜鞘膜积液术中发现。12例患侧内环口均呈宽大洞穴状,患侧均发现未闭合鞘状突。5例合并对侧异常,其中鞘膜积液4例,腹股沟斜疝1例。12例均采用腹腔镜囊壁部分切除联合内环口修复完成。术后随访6~37个月,未发现鞘膜积液或斜疝复发,睾丸无萎缩。结论腹腔镜囊壁部分切除联合内环口修复治疗小儿腹阴囊鞘膜积液疗效确切、安全可行。

Objective To evaluate the feasibility and safety of laparoscopic partial excision of the cyst wall combined with internal inguinal ring repair in the treatment of pediatric abdominoscrotal hydrocele(ASH).Methods Clinical data of 12 ASH children treated during Mar.2017 to May 2020 were retrospectively analyzed,including clinical manifestations,preoperative diagnosis,intraoperative findings,and postoperative results.Results A preoperative diagnosis of ASH was made in 9 cases.In the other 3 cases,ASH was detected during laparoscopic repair of the hydrocele.The opening of the internal inguinal ring was wide and cavernous,and patent processus vaginalis(PPV)was detectedin all cases.Contralateral pathologies were detected in 5 cases,including hydrocele in 4 and inguinal hernia in 1.All patients received laparoscopic partial excision of the cyst wall combined with internal inguinal ring repair.During the follow-up of 6-37 months,no recurrence of ASH or ipsilateral hernias occurred,and no testicular atrophy was observed.Conclusion Laparoscopic partial excision of the cyst wall combined with internal inguinal ring repair is effective,safe and feasible in the treatment of the pediatric ASH.