腹腔镜鞘状突高位结扎术中对侧鞘状突未闭的个体化处理效果  

Effects of individualized treatment of contralateral patent processus vaginalis during laparoscopic high ligation of processus vaginalis

作　　者：杨斌[1] 陈海涛[1] 范林林[1] 刘闯 李立伟 郭士磊 张潍平[2] YANG Bin;CHEN Haitao;FAN Linlin;LIU Chuang;LI Liwei;GUO Shilei;ZHANG Weiping(Department of Urology,Baoding Children s Hospital,Baoding 071000;Department of Urology,Children s Hospital Affiliated to Capital Medical University,Beijing 100045,China)

机构地区：[1]保定市儿童医院泌尿外科,河北保定071000 [2]首都医科大学附属儿童医院泌尿外科,北京100045

出　　处：《现代泌尿外科杂志》2023年第7期619-622,共4页Journal of Modern Urology

基　　金：保定市科学技术计划项目(No.18ZF082)。

摘　　要：目的探究腹腔镜鞘状突高位结扎术中对侧鞘状突未闭(CPPV)的合理处置方案。方法选取2018年6月-2020年6月在保定市儿童医院接受腹腔镜鞘状突高位结扎术的单侧腹股沟斜疝/鞘膜积液的患儿300例,采用随机数字表法分为两组,每组150例。对照组术中发现CPPV 53例,均给予同期手术处理;研究组术中发现CPPV 58例,对其中符合高位结扎条件的11例给予同期手术处理;比较两组患儿对侧腹股沟斜疝或鞘膜积液的再发率情况。结果术后随访1年,研究组与对照组再发率差异无统计学意义(8.62%vs.1.88%,P>0.05)。单侧鞘膜积液患儿CPPV检出率明显高于腹股沟斜疝患儿(49.07%vs.23.02%,P<0.001);左、右侧鞘状突未闭患儿CPPV检出率分别为42.71%、32.95%,差异无统计学意义(P=0.192);1~2岁年龄段CPPV检出率为62.93%,明显高于其他年龄段(P<0.001)。结论CPPV转化为腹股沟斜疝或鞘膜积液的发生率低,术中可仅对符合条件的患儿进行同期处理。Objective To explore the rational management of contralateral patent processus vaginalis(CPPV)in laparoscopic high ligation of processus vaginalis.Methods A total of 300 children with unilateral oblique inguinal hernia/hydrocele who received laparoscopic high ligation of processus vaginalis in Baoding Children s Hospital during Jun.2018 and Jun.2022 were selected and divided into two groups by random number table method,with 150 in either group.In the control group,53 cases of CPPV were found intraoperatively,which were treated simultaneously.In the study group,58 cases of CPPV were detected,among which 11 met the indications of high ligation and received simultaneous surgical treatment.The incidence of recurrence was compared between the two groups.Results After 1 year of follow-up,the recurrence rate was 8.62%in the study group and 1.88%in the control group(P>0.05).The detection rate of CPPV was 23.02%in children with unilateral inguinal hernia,significantly lower than that in children with unilateral hydrocele(49.07%,P<0.001).The detection rate of CPPV was 42.71%in children with left patent processus vaginalis and 32.95%in children with right patent processus vaginalis(P=0.19).The detection rate of CPPV was 62.93%in the age group of 1-2 years,significantly higher than that in other age groups(P<0.001).Conclusion The incidence of CPPV conversion into oblique inguinal hernia or hydrocele is low.Only children who meet the indications can be treated at the same time during surgery.

关 键 词：腹股沟斜疝 鞘膜积液 隐匿性鞘状突未闭 检出率 再发率 

分 类 号：R692[医药卫生—泌尿科学]