腹腔镜二孔法与开放手术治疗小儿腹股沟斜疝嵌顿的对比分析  

Comparative analysis of transumbilical double-hole laparoscopic and traditional operation in treatment of incarcerated inguinal hernia in children

作　　者：许冬阳 杨清渭 王书苗 XV Dongyang;YANG Qingwei;WANG Shumiao(Department of General Surgery,Shishi Hospital,Shishi,Fujian 362700,China)

机构地区：[1]福建省石狮市医院普通外科,石狮362700

出　　处：《福建医药杂志》2018年第4期29-33,共5页Fujian Medical Journal

摘　　要：目的探讨腹腔镜二孔法与传统开放手术治疗小儿腹股沟嵌顿性斜疝的疗效对比。方法回顾性分析我院2010年6月至2013年6月收治的45例进行传统开放手术治疗的小儿腹股沟嵌顿性斜疝患儿作为开放手术组;2013年6月至2016年6月收治的52例腹腔镜二孔法治疗小儿腹股沟嵌顿性斜疝的患儿作为腹腔镜组。对比两组手术时间、出血量、术后肛门排气时间、住院时间、术后复发率、术后切口感染及阴囊水肿发生率。结果腹腔镜组在手术时间、出血量、术后排气时间、住院时间方面与开放手术组比较有优势,差异有统计学意义(P<0.05);两组在复发率、切口感染率和阴囊水肿发生率方面差异无统计学意义(P>0.05)。结论腹腔镜治疗小儿腹股沟嵌顿性斜疝不破坏腹股沟管解剖结构,内环口结扎比开放手术更高位,而且是在直视下探查嵌顿内容物损伤及腹腔情况,同时可以发现对侧有无隐匿性疝。该技术安全、有效、微创,是值得推广的新技术。Objective To compare the effect of transumbilical double-hole laparoscopic surgery and traditional surgery on pediatric incarcerated indirect inguinal hernia.Methods Fourty-five pediatric patients with incarcerated indirect inguinal hernia treated with traditional surgery between June 2010 to June 2013（traditional group）,and 52 cases treated with laparoscopic twohole surgery between June 2013 to June 2016（laparoscopic group）were retrospectively analyzed.Comparison was performed between two groups regarding to operation time,amount of bleeding,postoperative anal exhaust time,hospitalization time,postoperative recurrence rate,postoperative incision infection and incidence of scrotal edema.Results Laparoscopic group was significantly superior to traditional group regarding to operation time,amount of bleeding,postoperative exhaust time and hospitalization time（P〈0.05）.No significant difference existed between two groups regarding to recurrence rate,incision infection rate and incidence of scrotal edema（P〉0.05）.Conclusion Laparoscopic two-hole surgery does not destroy the anatomical structure of the inguinal canal,with internal mouth ligation higher than traditional surgery.Furthermore,since the surgery can detect injury of incarcerated content and abdominal cavity under direct vision,it will be easy to find the occult hernia on the opposite side.Therefore,laparoscopic two-hole surgery is safe,effective,minimally invasive.

关 键 词：腹腔镜手术 开放手术 儿童 腹股沟嵌顿性斜疝 

分 类 号：R656.21[医药卫生—外科学]