腹腔镜囊肿开窗联合鞘状突结扎治疗儿童腹阴囊鞘膜积液的疗效分析  

Efficacy analysis of laparoscopic cyst fenestration and processus vaginalis high ligation in the treatment of abdominoscrotal hydrocele in children

作　　者：张玲玲[1] 刘华建 桂萌 张磊[1] 贺庆豹 王浩[1] 贺红嘉 李开升[1] ZHANG Lingling;LIU Huajian;GUI Meng(Department of Minimally Invasive Urology,Children's Hospital Affiliated to Shandong University,Jinan Children's Hospital,Jinan 250022,China)

机构地区：[1]山东大学附属儿童医院济南市儿童医院泌尿微创外科,山东济南250022

出　　处：《腹腔镜外科杂志》2024年第3期222-225,230,共5页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜囊肿开窗及鞘状突高位结扎术治疗小儿腹阴囊鞘膜积液的临床疗效。方法:回顾分析2021年2月至2022年11月诊治的13例腹阴囊鞘膜积液患儿的临床资料。患儿腹股沟至阴囊均可触及体积大、张力高的囊性包块,透光实验阳性。超声探查显示包块经腹股沟延伸至腹腔,积液量多,偶有分隔。囊性包块均从腹腔内自内环口处脱出,呈梨状。患儿中位手术年龄2.9(1.7~4.1)岁。结果:13例患儿中10例术前超声诊断为精索鞘膜积液,3例诊断为睾丸鞘膜积液。术中发现3例为腹腔内单发囊肿,10例合并对侧鞘状突未闭。13例患儿均行腹腔镜囊肿开窗及鞘状突高位结扎术,手术顺利完成,无一例中转开腹。术后随访6~27个月,查体及超声检查提示睾丸无缺血萎缩,均未再次出现临床症状。结论:腹腔镜囊肿开窗联合鞘状突结扎术治疗儿童腹阴囊鞘膜积液疗效显著,安全、可行。Objective:To investigate the curative effect of laparoscopic cyst fenestration and processus vaginalis high ligation in the treatment of children with abdominoscrotal hydrocele.Methods:Clinical data of 13 children with abdominoscrotal hydrocele from Feb.2021 to Nov.2022 were retrospectively analyzed.All the children underwent physical examination and were found to have a large and high tensile cystic mass palpable from the groin to the scrotum,with a positive light transmission.Ultrasound showed that the mass extended from the inguinal region to the abdominal cavity,with a large amount of fluid accumulation and occasional separation.The cystic masses were all pear shaped and protruded via the opening of the inner ring from the abdominal cavity.The median surgical age of the patients was 2.9(1.7-4.1)years.The clinical,imaging,intraoperative and postoperative manifestations of all patients were analyzed.Results:A total of 13 children were included in this study,10 with preoperative ultrasound diagnosis of spermatic hydrocele and 3 with preoperative ultrasound diagnosis of testicular hydrocele.During the operation,3 cases were found to be single cysts in the abdominal cavity,and 10 cases combined with contralateral patent processus vaginalis.All 13 cases were treated with laparoscopic fenestration and high ligation of processus vaginalis.All operations were successfully completed without conversion to open surgery.After follow-up of 6 to 27 months,physical examination and ultrasonography showed no ischemic atrophy of testis,and no recurrent clinical symptoms were found.Conclusions:Laparoscopic cyst fenestration and high ligation of processus vaginalis is effective,safe and feasible in the treatment of the pediatric abdominoscrotal hydrocele.

关 键 词：腹阴囊鞘膜积液 鞘状突高位结扎术 腹腔镜检查 囊肿开窗 儿童 

分 类 号：R697.23[医药卫生—泌尿科学]