探讨小儿滑动疝的临床特点及腹腔镜下经皮腹膜外疝囊高位结扎术治疗小儿腹股沟滑动疝的临床效果。

回顾性分析2014年3月至2016年2月，滨州医学院附属医院收治的283例腹腔镜腹膜外疝修补术治疗儿童腹股沟疝患者的临床资料，其中10例为滑动疝。对手术时间、术中出血、住院时间、手术并发症及术后复发率等指标进行统计学分析。

本组10例患儿均顺利完成手术，无中转腹股沟路径手术病例，手术时间25～60（37.6±13.1）min；术中出血2～10（3.95±2.26）ml；住院时间5～7（5.6±0.8）d。术中发现对侧隐匿疝2例，以同法处理。术后无阴囊积血、积液、腹痛发生。本组10例患儿均获随访，随访时间6～18个月，无复发病例。

小儿滑动性腹股沟斜疝多为Bendavid Ⅱ型，小儿腹股沟管短直，腹腔镜直视下疝内容物易于还纳复位和了解疝类型，避免脏器损伤。疝内容物充分还纳腹腔并高位结扎疝囊是预防复发的关键。腹腔镜经皮腹膜外疝修补术治疗儿童腹股沟滑动疝近期效果安全、有效，远期疗效有待于进一步随访观察。

The aims of this study are to evaluate the clinical characteristics of sliding inguinal hernia in children, and to evaluate the safety and feasibility of laparoscopic repair of sliding inguinal hernia.

Laparoscopic percutaneous extraperitoneal closure (LPEC) was performed in 283 inguinal hernia children admitted to Binzhou Medical University Hospital from March 2014 to February 2016. Ten of these patients were associated with sliding inguinal hernia, and these 10 patients were enrolled and reviewed retrospectively. The clinical data of their operating time, blood loss, length of stay, postoperative complications, and hernia recurrence were analyzed with statistical method.

There are 3 boys and 7 girls; the median age was 20.4 months; six patients were on left side (60%) and four patients were on right side (40%). Two were irreducible (20%) and three were incarcerated inguinal hernia (30%). One hernia content had appendix, one had appendix and cecum, one had sigmoid colon, three had ovary, four had Fallopian tube. The operation time was 25 to 60 minutes [mean (37.6±13.1)minutes]. the intraoperative blood loss was 2 to 10 ml (mean 3.95±2.26 ml), the length of hospital stay was 5 to 7 days [an average of (5.6±0.8)days]. Two contralateral patent processus vaginalis were detected and to perform LPEC simultaneously. There were no conversion to the inguinal approach in all patients. All of the patients were followed up for 6 to 18 months and no recurrence was found. Other postoperative complications were not observed.

Most of sliding inguinal hernia in children were the type II of Bendavid Classifications. The reduction of the sac is easier by LPEC approach and to confirm that the viscera actually forms the wall of the sac, thereby reducing the incidence of access related injuries and viscera injuries. The reduction of the sac completely and high ligation of the sac are the essential measures to reduce the risk of recurrence. LPEC is safe and feasible for the sliding inguinal hernia repair in children in the near future, and the long-term effect remains to be seen.