腹腔镜结合Bianchi手术治疗腹股沟型隐睾的效果观察

Laparoscopic Combined with Bianchi Operation for Inguinal Cryptorchidism

目的:探讨腹腔镜下Bianchi手术方式治疗腹股沟型隐睾患儿的手术效果及安全性。方法:选取我院2019年6月至2022年6月收治的120例腹股沟区隐睾患儿作为研究对象,采用简单随机分组方式将其分为研究组和对照组各60例,研究组采用腹腔镜下Bianchi手术方式治疗,对照组采用腹股沟横向小切口睾丸下降术治疗,对比两组的手术操作指标、手术前后血清性激素、白细胞介素-6(IL-6)、IL-8、超敏C反应蛋白(hs-CRP)、血清抗苗勒管激素(AMH)、抑制素B(INHB)水平变化,手术并发症的发生情况。结果:研究组的平均手术时间长于对照组,住院时间短于对照组,术中出血量、切口长度均小于对照组,差异均具有统计学意义(P<0.05);术前,研究组和对照组的基线血清T、E2、FSH、AMH、INHB水平比较,差异不具有统计学意义(P>0.05);术后3个月再次对上述各项血清激素指标进行检查,两组患儿血清AMH、INHB水平较本组术前显著升高,血清E2、FSH水平较本组术前显著降低,差异均具有统计学意义(P<0.05);在两组患儿手术后3个月上述各项指标组间进行对比,差异均无统计学意义(P>0.05);术前,研究组和对照组的基线血清IL-6、IL-8、hs-CRP水平比较,差异不具有统计学意义(P>0.05);术后1d,研究组的血清IL-6、IL-8、hs-CRP测定值均低于对照组,差异均具有统计学意义(P<0.05);两组患儿手术后1d的IL-6、IL-8、hs-CRP测定值均高于本组术前,差异均具有统计学意义(P<0.05);研究组并发症发生率为8.33%,低于对照组的28.33%,差异具有统计学意义(P<0.05)。结论:腹腔镜下Bianchi手术方式治疗腹股沟型隐睾患儿的手术效果肯定,并发症少,值得临床推广应用。

Objective:To investigate the effect and safety of laparoscopic Bianchi operation in the treatment of inguinal cryptorchidism in children.Methods:Totally 120 children with cryptorchidism in inguinal area admitted to our hospital from June 2019 to June 2022 were selected as the research subjects.They were randomly divided into study group and control group,with 60 cases in each group.The study group was treated with Bianchi operation under laparoscope,and the control group was treated with a small testicular descending transverse inguinal incision.The operation indexes,serum sex hormones,interleukin-6(IL-6),IL-8 The changes of high sensitivity C-reactive protein(hs CRP),serum anti Mullerian hormone(AMH),inhibin B(INHB)levels and the occurrence of surgical complications.Results:The average operation time of the study group was longer than that of the control group,and the amount of intraoperative bleeding,incision length,and hospital stay were all smaller than those of the control group,with significant differences(P<0.05).Before operation,there was no significant difference in the baseline serum T,E2,FSH,AMH,INHB levels between the study group and the control group(P>0.05).Three months after operation,the above serum hormone indexes were checked again.The serum AMH,INHB levels in the two groups were significantly higher than those before operation,and the serum E2,FSH levels were significantly lower than those before operation,with statistically significant differences(P<0.05).There was no significant difference in the above indicators between the two groups 3 months after operation(P>0.05).Before operation,there was no significant difference in the baseline serum IL-6,IL-8,hs CRP levels between the study group and the control group(P>0.05).On the first day after operation,the serum IL-6,IL-8 and hs CRP in the study group were lower than those in the control group,with significant differences(P<0.05).The measured values of IL-6,IL-8 and hs CRP in the two groups on the first day after operation were significantly higher than those before operation(P<0.05).The incidence of complications in the study group was 8.33%,which was lower than that in the control group(28.33%,P<0.05).Conclusion:The effect of Bianchi operation under laparoscope in the treatment of children with inguinal cryptorchidism is positive,with few complications,which is worthy of clinical application.