内环口开放腹腔镜下隐睾伴同侧腹股沟斜疝手术的临床观察  

Clinical observation of laparoscopic surgery with nonsutured internal ring for pediatric cryptorchidism complicated with ipsilateral indirect inguinal hernia

作　　者：林家威[1] 邓洪强[1] 冯泽荣[1] 刘杨桦[1] 吴东波[1] 潘云[1] 

机构地区：[1]广西壮族自治区人民医院普通外科,小儿外科,南宁市530021

出　　处：《微创医学》2015年第3期307-309,共3页Journal of Minimally Invasive Medicine

摘　　要：目的探讨内环口开放腹腔镜治疗小儿隐睾伴同侧腹股沟斜疝的可行性。方法行内环口开放腹腔镜下隐睾伴同侧腹股沟斜疝手术治疗患儿23例术中充分游离精索血管及输精管,在同侧阴囊皮肤与肉膜之间建立标准肉膜袋,将睾丸向下牵引达肉膜袋内,与阴囊肉膜边缘缝合固定,内环口均未缝合关闭,观察手术时间、睾丸下降情况、并发症等。结果 23例鞘状突均未闭合,其中20例腹股沟管内隐睾,3例腹腔内隐睾;手术时间平均53 min,术中平均出血量约23.5 m L;23例将睾丸Ⅰ期下降固定,术后无切口感染、睾丸萎缩或回缩、腹股沟斜疝复发、粘连性肠梗阻及脐疝。结论内环口开放腹腔镜下隐睾伴同侧腹股沟斜疝手术是安全的,手术创伤小,恢复快,效果好。Objective To evaluate the feasibility of laparoscopic surgery with nonsutured internal ring for pediatric cryptorchidism complicated with ipsilateral indirect inguinal hernia. Methods 23 children with cryptorchidism complicated with ipsilateral indirect inguinal hernia were enrolled in this study. Laparoscopic surgery with nonsutured internal ring was performed in all cases. The initial management consisted of separa- tion of the spermatic vessels and vas deferens, and establishment of a standard dartos capsule between the ipsi- lateral scrotal skin and dartos. Then the testicle was pulled down into the dartos, and the periorchium was fixed to the edge of scrotal dartos with suture. The internal ring was not sutured and closed in all cases. The operative duration, profile of testicular descending, and complications were assessed. Results Patent proces- sus vaginalis was found in all cases. Of 23 cases, there were 20 cases with inguinal canal cryptorchidism, and 3cases with intra-abdominal cryptorchidism. The mean operative duration was 53 min, and the mean intraoper- ative blood loss was 23.5mL. Primary orchidopexy was performed in 23 cases. Postoperative incision infection, testicular atrophy or retraction, recurrence of indirect inguinal hernia and adhesive ileus and umbilical hernia did not occur. Conclusions The laparoscopic surgery with nonsutured internal ring is a safe and effec- tive approach for children with cryptorchidism complicated with ipsilateral indirect inguinal hernia. And it has the advantages of less trauma and faster recovery.

关 键 词：腹腔镜 隐睾 腹股沟斜疝 手术 

分 类 号：R726[医药卫生—儿科]