不同术式对成人腹股沟疝合并隐睾的疗效比较  

Comparison of the efficacy of different surgical treatments on inguinal hernia with cryptorchidism in adults

作　　者：刘园园[1] 赛米·赛麦提 李赞林[2] 李义亮[2] 赵从[1] Liu Yuanyuan;Saimi·Saimaiti;Li Zanlin;Li Yiliang;Zhao Cong(Operating Room,Hernia and Abdominal Wall Surgery,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China;Department of Minimally Invasive Surgery,Hernia and Abdominal Wall Surgery,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院手术室,乌鲁木齐830001 [2]新疆维吾尔自治区人民医院微创、疝和腹壁外科,乌鲁木齐830001

出　　处：《中华疝和腹壁外科杂志（电子版）》2021年第6期648-651,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

基　　金：新疆维吾尔自治区自然科学基金面上项目(2020D01C120)。

摘　　要：目的总结成人腹股沟疝合并隐睾的手术治疗体会。方法回顾性分析2010年1月至2018年1月于新疆维吾尔自治区人民医院就诊成人腹股沟疝合并隐睾患者38例。按照术式不同,将患者分为腹腔镜组和开放组。腹腔镜组给予腹腔镜下隐睾切除联合腹股沟疝修补术(27例),开放组给予行开放Lichtenstein术式联合隐睾切除(10例)和隐睾下降固定术(1例)。比较2组患者手术时间、术中出血量、术后住院时间及睾丸切除率。结果 38例患者手术均获得成功,腹腔镜组手术时间(58.45±11.71)min、术中出血量(7.11±2.11)ml、术后住院时间(4.09±1.11)d,开放组手术时间(57.83±8.91)min、术中出血量(7.25±1.11)ml、术后住院时间(4.99±1.08)d。2组患者在术后手术时间、术中出血量和睾丸切除率方面比较,差异无统计学意义(P>0.05);住院时间比较,差异有统计学意义(P<0.05);开放组术后1例患者出现阴囊血清肿,无其他并发症。随访6个月至6年,平均(48.9±13.1)个月,未见疝复发。结论成人腹股沟疝合并隐睾并不常见,腹腔镜手术与开放手术治疗成人腹股沟疝合并隐睾各具优势,均可取得较好效果,应在术前明确诊断的前提下,选择最佳手术方案。Objective Investigate the surgical treatment of inguinal hernia with cryptorchidism in adults.Methods A retrospective analysis of 38 adult patients with an inguinal hernia with cryptestes was at the People's Hospital of Xinjiang Uygur Autonomous Region from January 2010 to January 2018.Patients were divided into laparoscopic and open groups according to the surgical procedures.The laparoscopic group gave laparoscopic cryptorchidectomy combined with inguinal hernia repair(27 cases),and open Lichtenstein combined with cryptorchectomies(10 cases)and cryptorchidism descent fixation(1 case).The operation time,intraoperative bleeding volume,postoperative hospitalization time,and testicular resection rate were compared between the two groups of patients.Results All 38 patients had successful operations.The average operative time in the laparoscopic group was(58.45±11.71)minutes,the average intraoperative blood loss was(7.11±2.11)ml,the average postoperative hospital stay was(4.09±1.11),and the average in the open group was(57.83±8.91)minutes,the average intraoperative blood loss(7.25±1.11)ml,and the average postoperative hospital stay(4.99±1.08)days.There was no statistically significant difference in the operation time,intraoperative blood loss,and testicular resection rate among patients with different surgical methods(P>0.05),while the difference in hospital stay between the two groups was statistically significant(P<0.05);One patient in the open group developed scrotal seroma with no other complications.Follow-up was 6 months to 6 years,with an average of(48.9±13.1)months.No recurrence of hernia was observed.Conclusion Inguinal hernia with cryptorchidism is not common in adults. Laparoscopic surgery and open surgery can achieve good results in the treatment of adult inguinal hernia with cryptorchidism, and each has its own advantages. The best operation should be selected on the premise of definite diagnosis before operation.

关 键 词：疝 腹股沟 成人 隐睾 

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