腹腔镜自制疝修补针立体编织法治疗儿童腹股沟斜疝106例报告  

Laparoscopic homemade hernia needle three-dimensional braiding method in the treatment of children with inguinal indirect hernia:a report of 106 cases

作　　者：刘耀刚 张建军[2] 崔明哲 杨志忠 

机构地区：[1]河南省直第三人民医院,河南郑州450006 [2]郑州市第二人民医院

出　　处：《腹腔镜外科杂志》2015年第2期103-106,共4页Journal of Laparoscopic Surgery

摘　　要：目的：评价分析腹腔镜内环口缝合及疝囊高位结扎术（立体编织法）治疗儿童腹股沟斜疝（内环口直径〉1.5 cm）的临床价值与疗效。方法：2010年5月至2013年8月收治106例（132侧）腹股沟斜疝（内环口直径〉1.5 cm）患儿,其中男92例,女14例,均采用自主设计的儿童腹股沟疝修补针行腹腔镜内环口缝合及疝囊高位结扎术。结果：手术过程顺利,26例发现对侧隐性鞘状突未闭,手术时间单侧15~20 min,平均（17±6）min,双侧25~40 min,平均（28±8）min;术中出血量1~5 ml,术后恢复平稳,均于第2天出院,无一例出现精索、输精管损伤及术后阴囊水肿,106例患者术后随访11~56个月,平均（36±17）个月,无一例复发。结论：采用自主设计的儿童腹股沟疝修补针行腹腔镜内环口缝合并疝囊高位结扎术治疗儿童腹股沟斜疝（内环口直径〉1.5 cm）具有创伤小、康复快、疗效确切、无明显手术瘢痕的优点,术中可发现并同时治疗对侧隐匿性斜疝,值得临床推广。Objective：To evaluate the clinical value and therapeutic effect of laparoscopic suturing inner ring and high ligation of hernia sac（ three-dimensional braiding method） in the treatment of children with inguinal indirect hernia（ the diameter of inner ring 1. 5 cm）. Methods：From May 2010 to Aug. 2013,106 patients（92 males,14 females,132 sides） with inguinal indirect hernia（ the inner ring diameter 1. 5 cm） were enrolled in this study. All patients were treated by laparoscopic suturing inner ring and high ligation of hernia sac,with originally designed needle for pediatric inguinal hernia. Results：All of the operations were successful. Contralateral dormant incomplete closure of the processus vaginalis was found and treated simultaneously in 26 cases. The operative time for unilateral hernia was（17 ± 6） min（ range,15-20 min）,while（ 28 ± 8） min（ range,25-40 min） for bilateral hernia. Intraoperative blood loss was 1-5 ml. All the patients recovered uneventful and were discharged on the second day after operation. No injury of spermatic cord or vas deferens,or scrotal edema occurred. 106 patients were followed up for（36 ± 17） months（ range,11-56 months）,no recurrence was found. Conclusions：Laparoscopic suturing inner ring and high ligation of hernia sac using originally designed needle for pediatric inguinal hernia is a good treatment method for child inguinal indirect hernia（ the inner ring diameter 1. 5 cm） and worthy of clinical popularization. This procedure has advantages of mini-invasion,rapid recovery,obvious curative effect and obscure scar,contralateral dormant indirect hernia can be treated at the same time if found.

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]