缝线穿引器辅助单孔腹腔镜治疗小儿腹股沟斜疝60例疗效分析  

Efficacy of single-incision laparoscopy with suture guide in indirect inguinal hernia repair in children:an analysis of 60 cases

作　　者：黄杰 浦惠民 李新国 王虎[1] 王进 王亮 刘燕勇 张劲松 吴斌 崔其军 李浩 HUANG Jie;PU Huimin;LI Xinguo;WANG Hu;WANG Jin;WANG Liang;LIU Yanyong;ZHANG Jinsong;WU Bin;CUI Qijun;LI Hao(Department of Pediatric Surgery,Huainan Maternal and Child Health Hospital,Huainan,Anhui 232007,China)

机构地区：[1]淮南市妇幼保健院小儿外科,安徽淮南232007

出　　处：《安徽医药》2022年第10期1981-1984,I0002,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨缝线穿引器辅助单孔腹腔镜及常规腹腔镜治疗小儿腹股沟斜疝的临床疗效分析。方法选取2019年1月至2020年6月于淮南市妇幼保健院小儿外科收治120例小儿腹股沟斜疝,采用随机数字表法将其分为观察组和对照组,观察组60例病儿采用缝线穿引器,对照组60例病儿采用常规腹腔镜治疗,由同一主刀医师采取以上两种不同手术方式治疗小儿腹股沟斜疝;对比手术时间、术中血管损伤情况、手术后复发等。结果观察组5例术前诊断为双侧,55例术前诊断为单侧,其中单侧术中发现24例为双侧鞘状突未闭(或隐性疝),予以同期处理。对照组6例术前诊断为双侧,54例术前诊断为单侧,其中单侧术中发现26例为双侧鞘状突未闭(或隐性疝),予以同期处理。所有病人均顺利完成手术。观察组中双侧手术时间为(19.34±2.51)min,对照组中双侧手术时间为(19.25±2.52)min,差异无统计学意义(P>0.05);观察组中单侧手术时间为(10.42±1.50)min,对照组中单侧手术时间为(10.25±1.21)min,差异无统计学意义(P>0.05)。观察组中输精管血管损伤0例,对照组输精管血管损伤6例(10%),差异有统计学意义(P<0.05);观察组中精索血管损伤0例,对照组精索血管损伤5例(8.3%),差异有统计学意义(P<0.05)。观察组随访期间无复发,对照组随访期间有2例复发,差异无统计学意义(P>0.05)。结论单孔腹腔镜下使用缝线穿引器治疗小儿腹股沟斜疝可以达到常规腹腔镜治疗的相同效果,并具有创伤小、不易损伤血管、瘢痕隐蔽等优势,值得临床推广。Objective To explore the clinical efficacy of single-incision laparoscopy with suture guide and conventional laparoscopy in the treatment of indirect inguinal hernia in children.Methods Totally 120 cases of pediatric oblique inguinal hernia,who were admitted to Pediatric Surgery Department of Huainan Maternal and Child Health Hospital from January 2019 to June 2020,were chosen and assigned into observation and control groups by random number tables.Sixty children in observation group were treated with singleincision laparoscopy suture guide while the other 60 children in control group were treated with conventional laparoscopy.The treatments of indirect inguinal hernia in children by two different methods were performed by the same chief surgeon respectively.A comparison was made of the time of operation,the condition of vascular injury and the recurrence after operation.Results Five cases were diagnosed as bilateral indirect inguinal hernia before operation and 55 cases unilateral in observation group.Among unilateral cases,24 cases were found to be bilateral patent processus vaginalis(hidden hernia)during the surgery and were treated simultaneously.Six cases were diagnosed as bilateral indirect inguinal hernia before operation and 54 cases unilateral in control group.Among unilateral cases,26 cases were found to be bilateral patent processus vaginalis(hidden hernia)during the surgery and were treated simultaneously.All the patients successfully completed the operation.The time of operation for bilateral cases was(19.34±2.51)min in observation group and(19.25±2.52)min in control group,respectively.There was no significant difference(P>0.05).The time of operation for unilateral cases was(10.42±1.50)min in observation groupand(10.25±1.21)min in control group,respectively.There was no significant difference(P>0.05).No blood vessel injury of spermaductwas found in observation group,but 6(10%)cases of blood vessel injury of spermduct were found in control group;the difference was statistically significant(P<0.05)

关 键 词：疝 腹股沟 单孔腹腔镜 缝线穿引器 常规腹腔镜 小儿 

分 类 号：R726.5[医药卫生—儿科]