摘要
目的探讨脐缘单孔腹腔镜手术治疗小儿腹股沟管型隐睾的早期临床疗效。方法2020年9月~2022年3月我科对53例小儿腹股沟管型隐睾(左侧19例,右侧31例,双侧3例)采用腹腔镜镜头由内环口伸入腹股沟管并确定睾丸位置后,利用腹腔镜镜头顶住患侧鞘膜囊,沿腹股沟管下行入患侧阴囊,于阴囊底部腹腔镜头冷光源处做一横切口,腹腔镜镜头将鞘膜囊顶至切口外,打开鞘状突后拖出睾丸,横断鞘膜囊,必要时行精索和输精管的游离,无张力固定睾丸于患侧阴囊皮肤肉膜间。结果手术均顺利完成,无中转开放手术,术中探查见患侧内环口均未闭合,对侧内环口未闭合占单侧隐睾患儿42.0%(21/50),同期行高位结扎术。手术时间(35.5±6.6)min。53例术后3、6、12、18个月患侧阴囊彩超提示所有患儿患侧睾丸血供良好,未出现睾丸回缩、萎缩,患侧无腹股沟斜疝、鞘膜积液等并发症。术前彩超睾丸体积(0.69±0.25)ml,与末次随访(0.92±0.32)ml比较差异有统计学差异(t=13.083,P=0.000)。结论脐缘单孔腹腔镜手术治疗小儿腹股沟管型隐睾可行,不破坏患侧腹股沟管结构,能发现并同时结扎对侧鞘状突,短期疗效满意。
Objective To explore the early clinical effect of single-port laparoscopic surgery for inguinal canal cryptorchidism in children.Methods From September 2020 to March 2022,53 children with inguinal canal cryptorchidism(19 on the left side,31 on the right side,and 3 on both sides)underwent single-port laparoscopic surgery.The laparoscopic lens was inserted into the inguinal canal from the inner ring opening to determine the location of the testis.By using the laparoscopic lens to hold the affected side of the scrotum,the affected side of the scrotum was entered descending the inguinal canal.A transverse incision was made at the cold light source of the abdominal lens at the bottom of the scrotum.By using the laparoscopic lens,the scrotum was pushed to the outside of the incision.The tunica vaginalis was opened and the testicles were pulled out.Then the tunica vaginalis was transected.If necessary,the spermatic cord and vas deferens were loosen.Finally the testicles were fixed between the sarcolemma of the affected scrotal skin without tension.Results All the operations were successfully completed without conversion to open operation.During the operation,it was found that the inner ring opening on the affected side was not closed,and 42.0%(21/50)of children with unilateral cryptorchidism had the opposite inner ring opening not closed.High ligation surgery was performed at the same time.The operation time was(35.5±6.6)min.All the 53 children were followed up at 3,6,12,and 18 months after operation.The scrotal color ultrasound showed that the testicular blood supply was good in all the cases,without testicular retraction and atrophy.There were no complications such as indirect inguinal hernia or hydrocele on the affected side.The preoperative color ultrasonography showed the testicular volume being(0.69±0.25)ml,which had a statistically significant difference as compared to the last follow-up[(0.92±0.32)ml,t=13.083,P=0.000].Conclusions The single-port laparoscope at the edge of umbilicus is feasible in the treatmen
作者
陈进
段光琦
刘洁
唐睿
随帮志
王啸
徐旭东
晋志远
马鸿龙
Chen Jin;Duan Guangqi;Liu Jie(Department of Pediatric Surgery,First Affiliated Hospital of Wannan Medical College,Wuhu 241000,China)
出处
《中国微创外科杂志》
CSCD
北大核心
2023年第4期267-271,共5页
Chinese Journal of Minimally Invasive Surgery
关键词
腹腔镜
隐睾
腹股沟
Laparoscope
Cryptorchidism
Groin
