摘要
目的探讨单切口腹腔镜疝囊高位结扎术在儿童复发性腹股沟疝中的应用价值。方法回顾性分析2011年1月~2016年2月我院单切口腹腔镜治疗30例儿童复发性腹股沟疝的临床资料。年龄1~11岁,(6.1±3.3)岁。对斜疝采用腹腔镜下带线针、钩针配合,内环口腹膜外潜行置线、荷包结扎的方法高位结扎疝囊;对直疝用类似方法结扎疝囊,同时将脐动脉襞缝合覆盖于直疝三角,起到加固作用。结果术中证实28例为斜疝复发,其中4例对侧存在隐匿性斜疝;2例为直疝。手术时间12~45 min,(21.4±8.2)min。30例随访2~53个月,(23.9±12.5)月,均无再次复发。术后瘢痕隐蔽,无并发症。结论单切口腹腔镜治疗儿童复发性腹股沟疝安全有效,瘢痕隐蔽,并可术中诊断处理隐匿性疝、直疝。
Objective To investigate the clinical value of single-incision laparoscopic inguinal high ligation in children with recurrent inguinal hernia. Methods Clinical data of 30 pediatric recurrent inguinal hernia cases treated with single-incision laparoscopy in our hospital between January 2011 and February 2016 were analyzed retrospectively. The patients were aged 1-11 years old（ mean,6. 1 ± 3. 3 years old）. For indirect inguinal hernia,a non-absorbable suture was placed around the extra-peritoneal space of the inguinal inner ring by means of a needle with a thread hole and a hooked needle under laparoscope,and the hernial sac was highly ligated by knotting the purse string suture. If a direct inguinal hernia was identified,a similar method was used to ligate the hernial sac,and the umbilical artery fold was sutured to the Hesselbach＇s triangle in order to enhance the weak tissue. Results After surgeries,we found 28 cases were recurrent indirect inguinal hernia（ 4 cases with contralateral concealed hernia）,and the other 2 cases were direct inguinal hernia. The operation time ranged from 12 to 45 min（ mean,21. 4 ± 8. 2 min）. All th cases recovered with inconspicuous scars,and no recurrence or complications were found during a follow-up for 2-53 months（ mean,23. 9 ± 12. 5months）. Conclusions Single-incision laparoscopic inguinal high ligation is a safe and effective procedure for children with recurrent inguinal hernia. This procedure does not cause obvious scars for patients,and can diagnose and treat the occult hernia and direct hernia at the same time.
出处
《中国微创外科杂志》
CSCD
北大核心
2017年第3期231-233,共3页
Chinese Journal of Minimally Invasive Surgery
基金
上海自然科学基金(面上)项目(13ZR1426300)
关键词
疝
腹股沟
复发
腹腔镜
儿童
Hernia
Inguinal
Recurrence
Laparoscopy
Children
