超微通道经脐单孔腹腔镜手术与常规三孔腹腔镜手术治疗小儿腹股沟型隐睾的效果

Effect of Ultramicro-channel Transumbilical Single-hole Laparoscopic Surgery and Conventional Three-hole Laparoscopic Surgery in the Treatment of Children with Inguinal Cryptorchidism

目的:比较超微通道经脐单孔腹腔镜手术与常规三孔腹腔镜手术治疗小儿腹股沟型隐睾的效果。方法:回顾性分析2017年10月—2022年7月福建医科大学附属泉州第一医院收治的348例腹股沟型隐睾患儿的临床资料。根据手术方式的不同将其分为对照组(193例)和观察组(155例)。对照组采用常规三孔腹腔镜手术,观察组采用超微通道经脐单孔腹腔镜手术。比较两组临床疗效,围手术期指标,并发症,术后1个月睾丸血运,腹部瘢痕长度。结果:两组治疗总有效率比较,差异无统计学意义(P>0.05)。两组手术时间比较,差异无统计学意义(P>0.05);观察组术中出血量少于对照组,术后住院时间短于对照组,差异有统计学意义(P<0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。观察组术后1个月收缩期峰值血流速度(PSV)、舒张末期最小血流速度(MOV)与阻力指数(RI)均低于对照组,差异有统计学意义(P<0.05)。观察组腹部瘢痕长度短于对照组,差异有统计学意义(t=21.150,P<0.001)。结论:与常规三孔腹腔镜手术治疗相比,超微通道经脐单孔腹腔镜手术术中出血量更少、术后住院时间更短,对睾丸血运影响更小。

Objective:To compare the effect of ultramicro-channel transumbilical single-hole laparoscopic surgery and conventional three-hole laparoscopic surgery in the treatment of children with inguinal cryptorchidism.Method:The clinical data of 348 children with inguinal cryptorchidism admitted to Pediatric Surgery Department of Quanzhou First Hospital Affiliated to Fujian Medical University from October 2017 to July 2022 were retrospectively analyzed.They were divided into control group(193 cases)and observation group(155 cases)according to the different operation methods.The control group underwent conventional three-hole laparoscopic surgery,and the observation group underwent ultramicro-channel transumbilical single-hole laparoscopic surgery.The clinical efficacy,perioperative indexes,complications,testicular blood flow 1 month after surgery and abdominal scar length were compared between the two groups.Result:There was no significant difference in the total effective rate between the two groups(P>0.05).There was no significant difference in surgery time between the two groups(P>0.05).The intraoperative blood loss volume in the observation group was less than that in the control group,and the postoperative hospitalization time was shorter than that in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).At 1 month after surgery,the peak systolic blood flow velocity(PSV),end-diastolic minimum blood flow velocity(MOV)and resistance index(RI)of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The abdominal scar length in the observation group was shorter than that in the control group,and the difference was statistically significant(t=21.150,P<0.001).Conclusion:Compared with conventional three-hole laparoscopic surgery,ultramicro-channel transumbilical single-hole laparoscopic surgery has less blood loss,shorter postoperative hospital stay,and less influence on testicular blood flow.