脐缘双通道腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝  

Treatment of transumbilical double-port laparoscopic high ligation of hernia sac on pediatric indirect inguinal hernia

作　　者：陈帅[1] 胡元军[1] 武玉睿[1] 张士松[1] 王合锋[1] 

机构地区：[1]山东大学齐鲁儿童医院普外新生儿外科,山东济南250022

出　　处：《山东大学学报（医学版）》2016年第4期74-77,共4页Journal of Shandong University:Health Sciences

摘　　要：目的探讨经脐缘双通道腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝的疗效。方法回顾性分析2014年9月~2015年5月脐缘双通道腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝112例临床资料。其中术前诊断右侧腹股沟斜疝81例,左侧23例,双侧8例。经脐左右缘皮肤皱褶处双通道行腹腔内缝合疝囊高位结扎术,探查并处理对侧,评估手术疗效。结果所有手术均在腹腔镜操作下完成,无中转开放。术中探查见右侧患病对侧鞘状突未闭31例,左侧患病对侧鞘状突未闭11例。手术时间：右侧平均22.7 min,左侧平均30.4 min,双侧平均43.2 min。术后恢复顺利,第2日即可下床活动,无明显疼痛感。随访3个月未见复发病例,无脐疝发生,无睾丸萎缩,瘢痕几乎不可见。结论脐缘双通道腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝疗效确切,瘢痕更隐蔽,对脐环及腹股沟管结构创伤小,恢复快,具有推广意义。Objective To explore the clinical efficacy of transumbilical double-port laparoscopic high ligation of hernia sac in the treatment of pediatric indirect inguinal hernia in children. Methods Clinical data of 112 children w ith indirect inguinal hernia w ho underw ent transumbilical double-port laparoscopic during Sept. 2014 and M ay 2015 w ere retrospectively analyzed. Preoperative diagnosis decided that 81 cases had hernia on the right side,23 cases on the left,and8 cases on both sides. Results All operations w ere completed w ith the laparoscope,and no case turned to open operation. Of the 81 cases w hich w ere diagnosed to have hernia on the right side,31 w ere found to have contralateral patent processus vaginalis. Of the 23 cases w hich w ere diagnosed to have hernia on the left side,11 had contralateral patent processus vaginalis. The operation time w as 22. 7 mins,30. 4 mins,and 43. 2 mins for hernia on the right side,left side and bilateral sides. All patients recovered w ell. No complications such as umbilical hernia and orchiatrophy occurred. The scars w ere almost invisible. Conclusion It is safe and feasible to treat pediatric indirect inguinal hernia by transumbilical double-port laparoscopic high ligation of hernia sac. It is minimal invasive and patients can recover rapidly. Therefore,it is w orth w ide clinical use.

关 键 词：脐缘双通道 腹股沟斜疝 腹腔镜 

分 类 号：R726.1[医药卫生—儿科]