腹腔镜与开放手术治疗小儿嵌顿性腹股沟斜疝临床疗效分析  

Clinical effect of laparoscopic and open surgery for incarcerated indirect inguinal hernia in children

作　　者：洪艺楠 位永娟 陈伟明 Hong Yinan;Wei Yongjuan;Chen Weiming(Department of Pediatric Surgery,Quanzhou Women's and Children's Hospital,Quanzhou 362000,Fujian,China)

机构地区：[1]泉州市妇幼保健院儿童医院小儿外科,福建泉州362000

出　　处：《中国现代手术学杂志》2023年第3期198-201,共4页Chinese Journal of Modern Operative Surgery

摘　　要：目的比较腹腔镜与开放手术治疗小儿嵌顿性腹股沟斜疝的临床效果。方法回顾性分析2018年1月至2022年1月我科急诊手术治疗的171例嵌顿性腹股沟斜疝患儿的临床资料,其中行腹腔镜手术(LG组)89例,开放手术(OG组)82例。比较两组的临床效果。结果两组患儿均顺利完成手术。嵌顿疝内容物,LG组小肠46例,回盲部9例,结肠23例,大网膜1例,卵巢10例,OG组小肠49例,回盲部5例,结肠22例,大网膜2例,卵巢4例。两组术中均未见嵌顿疝内容物穿孔或坏死。两组比较,LG组手术时间及麻醉时间均明显短于OG组,差异均有统计学意义(P<0.05)。LG组术前诊断双侧腹股沟斜疝7例(7.87%),术中发现对侧隐匿性鞘状突未闭29例(32.58%);OG组术前诊断双侧腹股沟斜疝6例(7.32%)。两组患儿术后均获随访,随访时间1~5年。两组患儿术侧均无复发;OG组术后发现对侧腹股沟斜疝而再次手术8例(9.76%)。结论腹腔镜手术治疗小儿嵌顿性腹股沟斜疝安全可行,既可明显缩短手术及麻醉时间,又能同时治疗对侧存在的隐匿性鞘状突未闭,降低再手术率,可作为小儿嵌顿性腹股沟斜疝手术治疗的首选方式。Objective To compare the efficacy of laparoscopic and open surgery in the treatment of incarcerated indirect inguinal hernia in children.Methods A retrospective analysis was carried out in 171 children with incarcerated indirect inguinal hernia admitted from January 2018 to January 2022.All children were divided into two groups according to surgical procedure,and treated by laparoscopy(LG group,89 cases)and open surgery(OG group,82 cases)respectively.Results The contents of incarcerated hernia was small intestine in 46 cases,ileocecal in 9 cases,colon in 23 cases,greater omentum in 1 case and ovary in 10 cases of LG group,and small intestine in 49,ileocecal in 5,colon in 22,greater omentum in 2 and ovary in 4 of OG group.No perforation or necrosis of incarcerated hernia contents was found in both groups.Compare to OG group,the operation time and anesthesia time was shorter in LG group,and the differences were significant(P<0.05).7 cases(7.87%)of LG group and 6 cases(7.32%)of OG group were diagnosed with bilateral indirect inguinal hernia before surgery,and 29 cases(32.58%)were found contralateral occult patent processus vaginalis during the surgery in the LG group.All cases were followed up for 1 to 5 years.There was no recurrence on the surgical side in both groups,and reoperation was performed due to contralateral inguinal hernia in 8 cases(9.76%)of OG group.Conclusion Laparoscopic surgery is safe and feasible with shortening surgical and an-esthesia time significantly,treating the contralateral occult patent processus vaginalis simultaneously and reducing reoperation rate effectively,and it can be a preferred choice for incarcerated indirect inguinal hernia in children.

关 键 词：腹股沟斜疝 嵌顿性 腹腔镜手术 儿童 

分 类 号：R726.5[医药卫生—儿科]