摘要
目的探讨一针双线单孔单隧道腹腔镜疝囊高位结扎术的疗效。方法回顾性分析我院2017年10月~2018年10月100例腹腔镜疝囊高位结扎术临床资料,单孔及双孔组各50例。比较2组手术时间、住院时间、住院费用、术后疼痛评分及并发症等指标,记录切口愈合及复发情况。结果100例均顺利完成手术。与双孔组比较,单孔组手术时间短[单侧(10.3±1.1)min vs.(12.4±1.4)min,t=-7.742,P=0.000;双侧(13.5±1.3)min vs.(16.1±1.3)min,t=-4.576,P=0.000],疼痛评分低[(2.4±0.3)分vs.(3.5±0.9)分,t=-8.553,P=0.000]。2组术后住院时间、住院费用差异无统计学意义(P>0.05)。随访5~17个月,平均12.1月。双孔组2例皮下线结反应,1例复发,单孔组均未发生,但差异无统计学意义(P>0.05);双孔组8例腹壁有可见瘢痕,单孔组均无可见瘢痕(P=0.006)。结论一针双线单孔单隧道腹腔镜疝囊高位结扎术是一种安全有效的手术方法,既避免在腹壁上戳孔,同时又确保完全腹膜外疝囊高位结扎,手术时间短,术后疼痛轻,且不额外增加患者经济负担,安全有效,值得在基层医院推广。
Objective To explore the efficacy of laparoscopic high ligation of the hernia sac with one-needle double-suture via a single-port and a single tunnel for indirect inguinal hernia in children.Methods A respective analysis was made on 100 cases of children with laparoscopic high ligation of the hernia sac from October 2017 to October 2018.The patients were divided into single-port group or double-port group according to the parental choice,with 50 children in each group.The operation time,hospital stay,hospitalization expenses,postoperative pain assessment and complications were compared between the two groups.Results The operations were completed smoothly in all the patients.The operative time of the single-port group was significantly shorter than that of the double-port group[one-side:(10.3±1.1)min vs.(12.4±1.4)min,t=-7.742,P=0.000;both sides:(13.5±1.3)min vs.(16.1±1.3)min,t=-4.576,P=0.000].The pain score of the single-port group was significant lower than the double-port group[(2.4±0.3)vs.(3.5±0.9)points,t=-8.553,P=0.000].However,the hospital stay and hospitalization expenses of the single-port group had no significant difference as compared with the double-port group(P>0.05).All the patients were followed up for 5-17 months(mean,12.1 months).The double-port group had 2 cases of subcutaneous line-knot reaction and 1 case of recurrence,and no complication was found in the single-port group(P>0.05).Eight cases in the double-port group had visible operative scars on the abdominal wall,and there was no visible scar in the single-port group(P=0.006).Conclusions One-needle double-suture via single-port and single-tunnel laparoscopic hernia sac high ligation is a safe and effective operation method,which not only avoids the puncture on the abdominal wall,but also ensures the high ligation of the complete extraperitoneal hernia sac.It is safe and effective,which should be popularizing in the primary level hospitals.
作者
明葛东
朱鸿喜
陈晨
孟德诚
戴文文
Ming Gedong;Zhu Hongxi;Chen Chen(Department of Pediatric Surgery,Yancheng Maternity and Child Health Care Hospital,Yancheng 224001,China)
出处
《中国微创外科杂志》
CSCD
北大核心
2019年第10期929-932,共4页
Chinese Journal of Minimally Invasive Surgery
基金
江苏省妇幼健康科研基金项目(F201854)
江苏省盐城市医学科技发展计划项目(YK2017045)
关键词
单孔
腹腔镜
疝囊高位结扎术
Single-port
Laparoscopy
High ligation of hernial sac
