摘要
目的：比较腹腔镜与传统腹横纹小切口手术治疗小儿腹股沟斜疝的效果。方法回顾性分析安徽医科大学附属安庆医院小儿外科2011年9月—2013年3月收治456例小儿腹股沟斜疝患儿的临床资料,其中230例采用腹腔镜（腹腔镜组）手术治疗,226例采用腹横纹小切口（传统手术组）手术治疗,比较两种术式的疗效及并发症。结果腹腔镜组：术中发现62例（26.96%,62/230）合并对侧鞘状突未闭,同时行对侧疝囊高位结扎,全组无一例中转开腹；单侧手术时间（19.3±5.4）min,双侧手术时间（26.8±6.2）min；切口均I期愈合,无明显手术瘢痕；术后阴囊肿胀3例,无阴囊血肿和医源性隐睾病例；随访3~21个月,复发2例。传统手术组：单侧手术时间（20.8±6.5）min,双侧手术时间（28.6±7.8）min；患儿切口下有少量积液3例,切口感染1例,阴囊肿胀202例,阴囊血肿9例,医源性隐睾2例；随访3~21个月,复发4例,对侧新发7例。两组患儿单侧和双侧手术时间、切口感染率、医源性隐睾率、术后复发率比较,差异均无统计学意义（P值均〉0.05）；阴囊肿胀、阴囊血肿及对侧新发疝发生率比较,腹腔镜组均低于传统手术组,差异均有统计学意义（P值均〈0.05）。结论腹腔镜与传统腹横纹小切口手术比较,具有切口美观,术后阴囊肿胀、血肿发生率低等优点,可同时发现并处理对侧隐匿性疝,术后对侧新发率低,是一种安全、可靠、有效的手术方式。
Objective To compare the curative effect of laparoscopic and small incision surgery on pediatric indirect inguinal hernia. Methods A retrospective analysis was conducted on 456 patients with indirect inguinal hernia in Padiatric Surgery of Anqing Hospital Affiliated to Anhui Medical University from September 2011 to March 2013. In which 230 patients were treated with laparoscopic procedure （ laparoscopic group） and 226 patients were treated by small incision surgery （ traditional operation group） . The treatment efficacies of two kinds of operation mode were analyzed retrospectively. Results In laparoscopic group, 62 patients （26. 56%,62/230） with contralateral processus vaginalis were detected intraoperatively and high ligated simultaneously. There was no case converted to laparotomy, and all of the incision healed in stage Ⅰ with no obvious scar in laparoscopic group. The unilateral and bilateral repair operative time of laparoscopic procedure were （19. 3 ± 5. 4） min and （26. 8 ± 6. 2） min,respectively. In laparoscopic group, there were 3 patients of postoperative swelling of the scrotum, and no cases with scrotal hematoma and iatrogenic cryptorchidism, 2 patients of recurrence in the follow-up of 3 -21 months. The unilateral and bilateral repair operative time in small incision surgery group were （20. 8 ± 6. 5） min and （28. 6 ± 7. 8 ） min, respectively. There were 3 patients with incision effusion and 1 patients of wound infection after operation. In traditional operation group, there were 202 patients of postoperative swelling of the scrotum, 9 patients with scrotal hematoma, and 2 patients with iatrogenic cryptorchidism, 4 patients of homolateral and 7 patients of contralateral recurrence in the follow-up of 3 -21 months. There was no significant difference between two groups in the operation time and the rate of incision infection, iatrogenic cryptorchidism and recurrence after operation （all P values〉0. 05）. The rate of scrotum swelling, scrotal hematoma and contrala
出处
《中华解剖与临床杂志》
2015年第3期245-248,共4页
Chinese Journal of Anatomy and Clinics
关键词
疝
腹股沟
腹腔镜
儿童
Hernia, inguinal
Laparoscopic
Child
