摘要
目的探讨经脐单部位腹腔镜联合腹膜外注水法治疗儿童巨大腹股沟斜疝的效果。方法回顾性分析2019年6月~2022年9月我院65例内环口疝囊颈直径≥15 mm的原发性单侧巨大腹股沟斜疝患儿资料,其中37例行经脐单部位腹腔镜联合腹膜外注水法疝囊高位结扎术(经脐组),另28例行常规三孔腹腔镜疝囊高位结扎术(三孔组)。比较2组手术时间、术后24小时切口疼痛评分、住院时间、切口并发症及术后1年复发和睾丸高位情况。结果2组均顺利完成手术,术中出血<2 ml,无术中并发症。经脐组术后24小时疼痛评分低于三孔组[1.0(1.0,1.0)分vs.3.0(2.0,3.0)分,Z=-6.182,P=0.000],2组手术时间、住院时间、切口并发症差异无统计学意义(P>0.05)。2组随访至术后1年,经脐组无复发、睾丸高位,三孔组1例复发(P=0.431),1例睾丸高位(P=0.422)。结论熟练掌握手术技巧后,经脐单部位腹腔镜联合腹膜外注水法治疗儿童巨大腹股沟斜疝,具有切口美观、恢复快、并发症少的优点。
Objective To investigate the clinical effect of transumbilical single site laparoscopy combined with extraperitoneal water injection in the treatment of large oblique inguinal hernia in children.Methods A retrospective analysis was performed on 65 children with primary unilateral giant inguinal hernia with cervical diameter≥15 mm in our hospital from June 2019 to September 2022.Among them,37 patients underwent high ligation of the hernia sac by transumbilical single site laparoscopy combined with external peritoneal water injection(transumbilical group).The other 28 patients underwent conventional three-port laparoscopic high ligation of hernia sac(three-port group).The operation time,incision pain score 24 hours after surgery,length of hospital stay,incision complications,and recurrence and high testicular position at 1 year after surgery were compared between the two groups.Results Both groups successfully completed the operation without intraoperative complications.The intraoperative bleeding was less than 2 ml.The 24 h postoperative pain score of the transumbilical group was lower than that of the three-port group[1.0(1.0,1.0)points vs.3.0(2.0,3.0)points,Z=-6.182,P=0.000].There was no significant difference in operation time,hospital stay and incision complications between the two groups(P>0.05).The two groups were followed up for 1 year after the operation.There was no recurrence or high testis in the transumbilical group,and 1 case of recurrence(P=0.431)and 1 case of high testis(P=0.422)in the three-port group.Conclusion After mastering the surgical skills,transumbilical single site laparoscopy combined with extraperitoneal water injection for the treatment of large inguinal hernia in children has the advantages of good cosmetic incision appearance,quick recovery,and few complications.
作者
何龙贵
何亦工
吴海彪
何少华
肖智祥
He Longgui;He Yigong;Wu Haibiao(Department of General Surgery,Wuyishan Municipal Hospital,Wuyishan 354300,China)
出处
《中国微创外科杂志》
CSCD
北大核心
2023年第8期592-596,共5页
Chinese Journal of Minimally Invasive Surgery
关键词
单部位腹腔镜手术
儿童
巨大
腹股沟斜疝
腹膜外注水法
Single site laparoscopy
Children
Giant
Oblique inguinal hernia
Extraperitoneal water injection
