腹腔镜疝囊高位结扎联合覆盖腹膜皱襞治疗小儿腹股沟斜疝  

Children with Indirect Inguinal Hernia Treated Laparoscopically by High Ligation of Hernia Sac Combined with the Coverage of Peritoneal Folds

作　　者：李利波[1] 张庭澍[1] 罗蓬[1] 曹云[1] 陈建名[1] 程化[1] 余志强[1] 

机构地区：[1]蓬安县人民医院小儿外科,四川蓬安637800

出　　处：《川北医学院学报》2011年第1期11-13,共3页Journal of North Sichuan Medical College

基　　金：南充市科技局项目(编号:南市科发2005年[41]号)

摘　　要：目的:探讨腹腔镜疝囊高位结扎联合覆盖腹膜皱襞治疗小儿腹股沟斜疝的可行性及临床意义。方法:对176例小儿腹股沟斜疝,行腹腔镜疝囊高位结扎、联合相邻的腹膜皱襞(脐内侧襞或脐正中襞)覆盖腹股沟管后壁及内环口治疗。结果:单侧手术时间(6-25)分钟,平均12分钟;双侧手术时间(13-35)分钟,平均20分钟。住院时间(2-4)天,平均2.7天。无近期并发症出院。全组随访1周-4年,6例大龄儿童术后短期内感腹股沟轻微牵扯不适,均无疝复发、异时疝、睾丸萎缩、肠粘连性腹痛、腹内疝及切口疝。结论:腹腔镜疝囊高位结扎联合覆盖腹膜皱襞治疗小儿腹股沟斜疝,便捷、可行,符合生理解剖,双重修复防止疝复发,拓宽了腹腔镜治疗小儿腹股沟斜疝的指征。Objective：To discuss the feasibility and clinical significance of children with indirect inguinal hernia treated laparoscopically by high ligation of hernia sac combined with the coverage of peritoneal folds.Methods： Of 176 cases of children with indirect inguinal hernia,the authors used laparoscopy to make high ligation of hernia sac and combined with the adjacent peritoneal folds（medial umbilical fold,or median umbilical fold） to cover the posterior wall of the inguinal canal and internal ring.Results： The unilateral operation time lasted 6-25min,the average time was 12min;the bilateral operation time lasted 13-35min,the average time was 20min.The hospital stays were 2-4d,the average day was 2.7d.All patients were discharged without short-term complications and were followed up 1 week-4 years,6 cases of older children have a sense of groin discomfort shortly after the operation.There was no hernia recurrence,metachronous hernia,testicular atrophy,adhesions of abdominal pain,abdominal hernia,and incisional hernia.Conclusion： The operation is suitable,feasible and consistent anatomically and physiologically.It has a double repair to prevent hernia recurrence and can widen the indications for laparoscopic treatment of indirect inguinal hernia in children.

关 键 词：腹腔镜 腹股沟疝 腹膜皱襞 儿童 

分 类 号：R726.1[医药卫生—儿科]