单孔腹腔镜无痕技术治疗小儿对侧隐性疝的临床效果分析  

Analysis on effect of single port laparoscopic traceless technology for child contralateral latent hernia

作　　者：欧荣册 李索林[2] 姜琳耀 肖琳 OU Rongce;LI Suolin;JIANG Linyao;XIAO Lin(Department of Pediatric Surgery,Mianyang 404 Hospital/Second Affiliated Hospital,Northern Sichuan Medical College,Mianyang,Sichuan 621000,China;Department of Pediatric Surgery,Second Hospital of Hebei Medical University,Shijiazhuang,Hebei 050000,China)

机构地区：[1]四川绵阳四○四医院/川北医学院附属第二医院小儿外科,621000 [2]河北医科大学第二医院小儿外科,石家庄050000

出　　处：《重庆医学》2018年第12期1592-1594,1598,共4页Chongqing medicine

基　　金：国家卫生与计划生育委员会公益性行业科研专项基金(201402007)

摘　　要：目的探讨单孔腹腔镜无痕技术治疗小儿对侧隐性疝的疗效。方法回顾性分析四○四医院2013年6月至2016年6月收治的312例单侧腹股沟斜疝手术患儿,其中采用单孔腹腔镜无痕技术170例,普通开放手术142例。分析两种手术患儿性别,年龄,复发率,单侧疝发病部位,开放手术术后发生对侧异时疝的病例数,腹腔镜发现对侧鞘状突未闭的病例数,以及术后异时疝的发生时间。结果普通开放手术共142例,男97.8%,女2.2%,平均年龄(2.45±2.18)岁;术后发生对侧异时疝5例,占3.5%,其中1例(0.7%)为右侧,4例(2.8%)为左侧,两者比较差异有统计学意义(χ~2=5.30,P=0.01),异时疝分别发生在术后8、14、18、20、24个月。有3例(2.1%)疝复发。腹腔镜手术共170例,男145例(85.3%),女25例(14.7%),平均年龄(2.44±2.15)岁,术中发现对侧鞘突未闭的隐性疝86例(50.6%),未发现异时性腹股沟斜疝,有1例(0.6%)在术后18个月复发,与开放手术患者比较差异有统计学意义(χ~2=10.12,P=0.01)。结论单孔腹腔镜治疗小儿单侧腹股沟斜疝较普通开放手术可准确判断有无对侧隐性疝并同时手术,其术后复发率和异时疝发生率均明显降低。Objective To explore the effect of single port laparoscopic traceless technology for child contralateral latent hernia.Methods Three hundred and twelve children cases of unilateral indirect inguinal hernia in Mianyang 404 Hospital from June 2013 to June 2016 were retrospectively analyzed.Among them,170 cases received single port laparoscopic traceless technology and 142 cases underwent common open surgery.The gender,age,recurrent rate,onset site of unilateral side,cases number of postoperative contralateral asynchrony hernia occurrence,cases number of contralateral vaginal process deformity found by laparoscopy and onset time of postoperative asynchrony hernia were compared between the two kinds of surgery.Results Among the 142 cases of common open surgery,male accounted for 97.8%and female accounted for 2.2%,and the average age was(2.45±2.18)years old;the postoperative contralateral asynchrony hernia occurred in 5 cases(3.5%),in which 1 case(0.7%)was in the right side and 4 cases in the left side,the difference between them was statistically significant(χ2=5.30,P=0.01),the asynchrony hernia occurred in postoperative 8,14,18,20,24 months.Three cases(2.1%)had hernia relapse.The laparoscopic surgery had 170 cases,including 145 male cases(85.3%)and 25 female cases(14.7%),the average age was(2.44±2.15)years old.The intraoperation found 86 cases(50.6%)of latent hernia of contralateral vaginal process deformity,while the asynchrony inguinal indirect hernia was not found,1 case had the relapse in postoperative 18 months,the difference was statistically significant compared with the patients with open surgery(χ2=10.12,P=0.01).Conclusion Single port laparoscopic surgery for treating child unilateral inguinal indirect hernia can accurately judge whether having contralateral latent hernia and simultaneously conducts the operation compared with the common open operation,its postoperative relapse rate and asynchrony hernia occurrence rate are significantly decreased.

关 键 词：疝 腹股沟 单孔 腹腔镜检查 鞘状突 

分 类 号：R726.1[医药卫生—儿科]