单孔腹腔镜经皮腹膜外疝囊高位结扎治疗小儿腹股沟斜疝的体会

Experience of single-port laparoscopic percutaneous extra-peritoneal high ligation of hernia sac for the treatment of inguinal indirect hernia in pediatrics

目的探讨单孔腹腔镜经皮腹膜外疝囊高位结扎治疗小儿腹股沟斜疝的临床效果和安全性。方法回顾性分析2021年1月—2021年12月,笔者所在医院疝外科收治并实施手术的158例患儿的临床资料。数据分析包括手术时长,术中对侧疝的发现率,术后并发症,复发率以及满意度问卷调查等资料。结果所有患儿均成功实施单孔腹腔镜经皮腹膜外疝囊高位结扎术。单侧手术时间为(16.00±3.87)min,双侧(25.00±4.54)min。前30例操作为手术的学习曲线。术中对侧疝发现率为3.16%(6/158)。术后复发率为1.30%(2/158),其中1例为女性患儿。术后无切口感染,阴囊血肿,慢性疼痛及睾丸萎缩等情况的发生。切口满意度问卷调查,平均分为4.8分(满分为5分)。结论单孔腹腔镜经皮腹膜外疝囊高位结扎治疗小儿腹股沟斜疝具有复发率低,术后并发症少和切口美观等优点。

Objective To investigate the clinical efficacy and safety of single-port laparoscopic percutaneous extra-peritoneal high ligation of hernia sac for the treatment of inguinal indirect hernia in pediatrics.Methods The study was a retrospective study.A total of 158 inguinal indirect hernias in children who underwent surgery in the Department of Hernia Surgery of our hospital from January 2021 to December 2021 were enrolled in this study.Clinical data including operative time,discovery rate of contra-lateral hernia in surgery,postoperative complications,recurrence rate,and score of satisfaction questionnaire for parents were collected and analyzed.Results Single-port laparoscopic percutaneous extra-peritoneal high ligation of hernia sac was successfully performed in all children.The operation time of unilateral hernia was(16.00±3.87)min,while that of bilateral hernia was(25.00±4.54)min.The operations on the first 30 cases were regarded as the learning curve of surgery.The discovery rate of contra-lateral hernia was 3.16%(6/158)in surgery.Furthermore,the rate of recurrence was 1.30%(2/158),one female and one male children.No incision infection,scrotal hematoma,chronic pain or testicular atrophy was found postoperatively.The average score of satisfaction questionnaire was about 4.8(total score=5).Conclusion Single-port laparoscopic percutaneous extra-peritoneal high ligation of hernia sac for the treatment of inguinal indirect hernia in pediatrics has the advantages of low rate of recurrence,fewer postoperative complications and excellent cosmetic results.