摘要
目的：探讨腹腔镜手术治疗小儿嵌顿性腹股沟斜疝的临床应用价值。方法：回顾分析2013年1月至2014年1月为33例嵌顿性腹股沟斜疝患儿行腹腔镜手术的临床资料。结果：9例麻醉后自动复位,17例腹腔镜下复位,7例难复性嵌顿疝经腹股沟小切口打开疝囊颈束环后腹腔镜下复位,33例复位成功后均行腹腔镜疝囊高位结扎术,14例同时行对侧隐匿疝治疗。7例打开疝囊颈束环者,丝线缝合修补并缩窄内环口,2例镜下同期切除阑尾。无一例中转开腹。手术时间平均（19.8±9.9）min,平均住院（3.2±1.1）d。术后无切口感染、阴囊血肿发生。随访3-12个月,无睾丸萎缩、复发等并发症发生。结论：腹腔镜下腹腔探查、嵌顿疝松解术及疝囊高位结扎术治疗小儿腹股沟嵌顿性斜疝安全、简便、暴露充分、微创、并发症少、术后康复快,术中可同时处理对侧隐匿性疝。
Objective： To investigate the clinical application value of laparoscopic operation in the treatment of pediatric incarcerated indirect inguinal hernia. Methods： The clinical data of 33 children who underwent laparoscopic treatment for incarcerated indirect inguinal hernia during Jan. 2013 and Jan. 2014 were retrospectively analyzed. Results： For 33 cases undergoing laparoscopic treatment,spontaneous remission was found in 9 patients after general anesthesia. Incarcerated hernia contents were restored under laparoscopy in 17 patients. 7 patients with severe incarcerated hernia were cured by cutting the hernia ring stricture through a inguinal small incision under laparoscope. All 33 patients underwent high ligation of inner ring. 14 cases of occult hernia on the opposite side were treated simultaneously. 7 patients underwent laparoscopic hernia lysis and high ligation combined with hernia ring constriction. 2 patients underwent appendectomy simultaneously. None of them needed laparotomy. The average operation time was（ 19. 8 ± 9. 9） min and the average hospital stay was（ 3. 2 ± 1. 1） d. In 3 to 12 months follow-up,no recurrence,wound infection,scrotum hematoma or testicular atrophy were observed. Conclusions： Laparoscopic abdominal exploration,incarcerated hernia lysis and high ligation of hernial sac are safe,simple and feasible to cure pediatric incarcerated indirect inguinal hernia. It is minimally invasive with adequate exposure,few complications and fast recovery. Meanwhile,occult inguinal hernia in the opposite side can be cured at the same time.
出处
《腹腔镜外科杂志》
2014年第9期667-669,共3页
Journal of Laparoscopic Surgery
关键词
疝
腹股沟
腹腔镜检查
嵌顿
儿童
Hernia
inguinal
Laparoscopy
Incarcerated
Child
