腹腔镜手术治疗小儿腹股沟斜疝临床疗效分析

Effect Analysis on Laparoscopic High Ligation for Pediatric Indirect Inguinal Hernia

目的探讨腹腔镜手术治疗小儿腹股沟斜疝的安全性和临床效果。方法回顾性分析我院外科2012年9月~2014年9月间收治的122例腹股沟斜疝患儿的临床资料,72例行腹腔镜疝囊高位结扎术(腹腔镜手术组),50例行传统手术高位结扎(传统手术组),比较两组临床效果。结果腹腔镜手术组患儿平均出血量少于传统手术组,手术时长、恢复自主活动时间和住院时间均短于传统手术组,差异具有统计学意义(P<0.05)。所有患儿均获随访,随访时间1~18个月,平均(10.3±2.9)个月。传统手术组术后并发症13例:阴囊水肿6例(12.0%),腹胀4例(8.0%),鞘膜积液3例(6.0%);复发2例(4.0%);腹腔镜组仅1例患儿阴囊轻微水肿,1周后自愈,无内环口过紧结扎、精索受损、切口感染、阴囊血肿及皮下血肿等并发症发生,手术几乎没有疤痕,且无一例复发。结论腹腔镜手术治疗小儿腹股沟斜疝安全、有效、微创,具有手术时间较短、术中出血量少、术后恢复快、并发症少和不易复发等优势,可在临床上推广应用。

Objective To explore the safety and effect of laparoscopic repair for indirect inguinal hernia in children. Methods A total of 122 children with oblique inguinal hernia from September 2012 to September 2014 in our hospital were analyzed retrospectively. 72 cases were treated by laparoscopic high ligation as laparoscopic group,and other 50 cases were performed conventional high ligation as conventional group. The intraoperative blood loss,the operative duration,the recovery time of spontaneous activity and hospital stays were compared between two groups. Results The average blood loss was less,the operative time,recovery time of autonomic activities and hospital stays were less in laparoscopic group than those in conventional group,there was statistical differences( P < 0. 05). All cases were followed up for 1 to 18 months with an average of(10. 3 ± 2. 9)months. In conventional group,postoperative complications were found in 13 cases,including6( 1 2 %) of scrotal edem a,4( 8 %) of abdom inal distension and 3( 6 %) of hydrocele of tunica vaginalis,and 2( 4 %) cases relapsed. Slight scrotal edema was found in 1 case in laparoscopic group. No complications as ligation tension of interior ring,spermatic cord injury,wound infection,scrotal hematoma and ecchymoma occurred. Conclusion The laparoscopy is a safe,effective and mini-trauma treatment for pediatric oblique inguina hernia with advantages as short operative time,less intraopeartive blood loss,quick postoperative recovery,less complication and lower recurrence rate.