单孔腹腔镜下“一针法”治疗小儿腹股沟斜疝的临床效果观察  

Single-incision One-stitch Laparoscopic Herniorrhaphy for Oblique Inguinal Hernia Repair in Children

作　　者：胡明华[1] 王小明[1] 孙卫东[1] 蒋亚琦[1] 王冠男[1] 方小三[1] 韩猛[1] 黄正米[1] 

机构地区：[1]皖南医学院弋矶山医院肝胆外科二病区,弋矶山241001

出　　处：《中国现代手术学杂志》2013年第5期356-358,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的介绍"一针法"单孔腹腔镜手术治疗小儿腹股沟斜疝的方法,探讨其相对于传统手术方式的优越性。方法将136例小儿疝气分为3组:传统手术组共54例,采用传统手术方法;常规腹腔镜组共38例,采用常用的双孔腹腔镜手术治疗;单孔"一针法"组共44例,采用改进的单孔腹腔镜"一针法"手术治疗。比较3组在手术效果和并发症等方面的差异。结果与传统的手术治疗组相比较,两种腹腔镜手术治疗组手术时间明显缩短,平均出血量明显减少,住院天数明显缩短,术后主诉疼痛及阴囊肿胀的例数明显少于传统手术组(P<0.05或P<0.01),且疝复发及对侧新发疝发生少于传统手术组(P<0.05);而"一针法"腔镜组在手术时间和减轻疼痛方面更优于常规腹腔镜组(P<0.05)。结论腹腔镜手术和传统手术比较,具有创伤小、操作简单、手术时间短、易恢复、瘢痕细微的优点。而腹腔镜下"一针法"疝囊高位结扎术更是在微创概念上更近一步,操作简易,手术时间更短,且易于推广,腹壁无可见疤痕,是治疗小儿腹股沟斜疝更好的术式选择。Objective To introduce the single-incision one-stitch laparoscopic herniorrhaphy for inguinal hernia repair in children and to compare the clinical efficacy with the traditional methods. Methods The 136 children with inguinal hernia were divided into three groups. In group A of 54 cases, the traditional high ligation of hernia was used. In group B of 38 cases, the routine laparoscopie herniorrhaphy with two incisions was used. And in group C of 44 cases, the single-incision one-stitch laparoscopic herniorrhaphy was used. The single-inci- sion one-stitch procedure was operated as follows, first, a single-incision laparoscopic port was inserted via an umbilical incision, and the 3mm laparoscope was used as inspection one, and the high ligation of the inner ring was done through the abdominal wall skin under the＂ laparoscopic inspection . After the sewing thread was shut off and the retracted into the abdominal wall, it can be confirmed as the inner ring was closed under the laparoscope. Results It showed the significant dominance of the laparoscopie procedure especially the single-incision one- stitch operation in the mean length of the operation,, the average blood loss, the hospital stay, the pain complain rate, the scrotum swelling rate and the recurrence rate（P 〈 0.05 or P 〈 0, 01 ）. Conclusions The single-inci- sion one-stitch herniorrhaphy is a novel surgical technique considered to be feasible and it is expected to improve the cosmetic outcome without any additional risk for inguinal hernia repair in children. .

关 键 词：疝 腹股沟 腹腔镜检查 儿童 

分 类 号：R726.5[医药卫生—儿科]