小儿鞘状突未闭畸形8418例

Patent vaginal process deformity in 8418 children

目的 总结小儿鞘状突未闭畸形的临床治疗经验。方法 回顾分析小儿鞘状突未闭畸形8 418例,其中腹股沟斜疝5261例;鞘膜积液2125例;隐睾1032例。结果 5261例腹股沟斜疝中,除12例腹股沟管后壁明显薄弱,行Bassini法疝修补术外,其余病例均行单纯疝囊高位结扎术治愈;2125例鞘膜积液均经鞘状突高位结扎治愈;1032例隐睾中,单侧皋丸缺如6例,左侧多睾畸形2例,假性多睾畸形1例。隐睾扭转5例,睾丸均已坏死,行切除术。其余病例均行鞘状突高位结扎术,高位隐睾31例,行分期固定术26例,Fowler-Stephens手术5例;中间位和低位隐睾均行肉膜囊固定法治愈。结论 小儿鞘状突未闭畸形适宜于1岁左右手术,行鞘状突高位结扎术,并处理相应的并发畸形。

AIM This study is designed to provide the experience in clinical treatment of patent vaginal process deformity (PVPD) in children. METHODS 8418 children with PVPD were retrospectively reviewed, among them 5261 cases were indirect inguinal hernia; 2125 cases were hydrocele of tunica vaginalis; 1032 cases were cryptorchidism. RESULTS Among the 5261 cases of inguinal hernia, all had had high ligation of vaginal process, but 12 cases had had Bsssini's hernia repair because of the posterior wall weak. All cases of hydrocele of tunica vaginalis had had high ligation of vaginal process and cured. For patients with cryptorchidism, absence of one side of testis in 6 cases, polytestes of the left side in 2 cases, pseudo-polytestes in one case, torsion of cryptorchidism in 5 cases and all testes had necrosis and received resection. The rest cases of cryptorchidism received high ligation, 26 cases of high cryptorchidism had had fixation and 5 cases had Fowler-Stephens operation, low and middle position of cryptorchidism were received sarcolemmiccyst fixation. CONCLUSION The appropriate operation time for children with PVPD is around one year old, high ligation of the vaginal process should be done and other complicated deformities should be managed.