儿童腹股沟巨大疝的诊治进展

Progress in diagnosis and treatment of huge inguinal hernia in children

腹股沟斜疝是儿童外科最常见的外科疾病,其主要原因是鞘状突闭合失败,而在腹压增大时出现临床症状,当患儿年龄超过1岁后内环口(IR)闭合概率降低,所以此时应进行治疗,且主要采取手术治疗。随着腹腔镜技术的发展,儿童腹股沟斜疝的微创治疗得到了广泛的开展。在腹腔镜下腹股沟斜疝可根据IR的直径分为巨大型(IR直径大于或等于1.5 cm)、普通型(IR直径0.5~<1.5 cm)、隐匿型(IR直径小于0.5 cm)。针对不同类型的腹股沟斜疝其术式也更加细化,而对于儿童巨大的腹股沟斜疝治疗也有多种术式。该文回顾性分析国内外相关文献,就儿童巨大腹股沟斜疝的诊治进展进行综述。

Indirect inguinal hernia is the most common surgical disease in pediatric surgery.The main season is the failure of sheath closure,and the clinical symptoms appear when the abdominal pressure increases.When the child is over one year old,the probability of closure of the inner ring decreases,so it should be treated at this time,mainly by surgery.With the development of laparoscopic technology,the minimally invasive treatment of pediatric inguinal hernia has been widely carried out.Laparoscopic indirect inguinal hernia can be divided into the giant type [inner ring(IR) diameter ≥1.5 cm],common type(IR diameter 0.5-<1.5 cm) and hidden type(IR diameter <0.5 cm) according to the IR diameter.The surgical methods for different types of indirect inguinal hernia are more detailed,and there are many surgical methods for the treatment of huge indirect inguinal hernia in children.This article retrospectively analyzes the relevant literatures at home and abroad,and reviews the diagnosis and treatment progress of giant indirect inguinal hernia in children.