迷你腹腔镜治疗隐睾合并同侧腹股沟疝的临床研究  

Clinical study on mini-laparoscopy for the treatment of undescended testicle with ipsilateral inguinal hernia

作　　者：袁广通[1] 韩修武[2] 朱绪辉[2] 杨宝森[1] 张鑫[2] 李涛[2] 李彦生[2] 曹金鑫[3] 刘素君[3] Yuan Guangtong;Han Xiuwu;Zhu Xuhui;Yang Baosen;Zhang Xin;Li Tao;Li Yansheng;Cao Jinxin;Liu Sujun(Department of Urology,People's Hospital of Suning County,Cangzhou 062350,China;Department of Urology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100043,China;Department of Hernia and Abdominal Wall Surgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100043,China)

机构地区：[1]河北省肃宁县人民医院泌尿外科,062350 [2]首都医科大学附属北京朝阳医院泌尿外科,100043 [3]首都医科大学附属北京朝阳医院疝和腹壁外科,100043

出　　处：《中华疝和腹壁外科杂志（电子版）》2020年第2期168-170,共3页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的探讨迷你腹腔镜治疗隐睾合并腹股沟疝的安全性和有效性。方法收集2010年10月至2018年10月于河北省肃宁县人民医院泌尿外科收治的21例隐睾合并同侧腹股沟疝患者。应用迷你腹腔镜(5.0 mm直径高清晰腹腔镜,2.8 mm的分离钳,持针器等)行微创治疗。对本研究患者进行回顾性分析。结果本组患者平均手术时间(95.0±12.3)min。因隐睾、精索发育不良,行阴睾切除疝囊高于结扎2例。6例患儿因分离精索、输精管时后腹膜缺损,内环口后腹膜未关闭。3例成人患者完成隐睾松解固定术后,内环口过大,遂将5.0 mm Trocar更换为10 mm Trocar。置入补片,缝合后腹膜。21例患者术后无阴囊血肿、阴囊感染、切口感染等并发症。术后无慢性腹股沟痛。2例术后分别为5.5年和1.7年一直睾丸较小,超声示睾丸萎缩。随访(6.6±3.4)年(0.3~8.7年),无疝复发。结论应用迷你腹腔镜治疗隐睾合并腹股沟疝是安全可靠的,损伤小、恢复快、并发症少。Objective To investigate the safety and effectiveness of mini-laparoscopy in the treatment of cryptorchidism with inguinal hernia.Methods A total of 21 patients with cryptorchidism and ipsilateral inguinal hernia admitted to the urology department of Suning county people's hospital of Hebei province from October 2010 to October 2018 were collected.Mini-laparoscopy(5.0 mm diameter high-definition laparoscope,2.8 mm separating forceps,needle holder,etc.)was used for minimally invasive treatment.The patients were retrospectively analyzed in this study.Results The operation time in this case series was(95.0±12.3)minutes.Of these,2 cases were performed with high ligation of hernia sac and cryptorchidectomy,due to hypoplasia of the spermatic cord and testis;6 patients had retroperitoneal defect after dissection of spermatic cord and vas deferens,and the inner ring was not closed.3 cases had excessively large inner ring after testicular detorsion and orchidopexy,and 5.0 mm trocar was replaced with 10 mm trocar.The peritoneum was sutured after mesh placement.There were no postoperative complications such as scrotal hematoma,scrotal infection,wound infection,and chronic pain.Two patients had remained small testes after 5.5 years and 1.7 years,respectively,and B-mode ultrasound showed testicular atrophy.After the follow-up of(6.6±3.4)years(range from 0.3 to 8.7 years),no hernia recurred.Conclusion The primary study indicates that it is safe and reliable to treat cryptorchidism with ipsilateral inguinal hernia by mini-laparoscopy,with less damage,faster recovery and fewer complications.It is worthy of clinical application.

关 键 词：疝 腹股沟 隐睾症 迷你腹腔镜 睾丸固定术 疝修补术 

分 类 号：R656.21[医药卫生—外科学] R699.8[医药卫生—临床医学]