切换至 "中华医学电子期刊资源库"

中华疝和腹壁外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (03) : 217 -220. doi: 10.3877/cma.j.issn.1674-392X.2019.03.007

所属专题: 经典病例 文献

论著

单孔腹腔镜下应用硬膜外穿刺针治疗小儿腹股沟斜疝682例
王小伟1, 卢飞1, 刘顶先1, 王松伟1, 莫宇轩2,()   
  1. 1. 236000 安徽阜阳疝病专科医院
    2. 315010 浙江省,中国科学院大学宁波华美医院胃肠疝外科
  • 收稿日期:2018-12-28 出版日期:2019-06-18
  • 通信作者: 莫宇轩

Single-port mini-laparoscopic treatment with epidural needle for children with indirect hernia: A report of 682 cases

Xiaowei Wang1, Fei Lu1, Dingxian Liu1, Songwei Wang1, Yuxuan Mo2,()   

  1. 1. Fuyang Hospital of Hernia Disease, Anhui, Fuyang 236000, China
    2. Department of Gastrointestinal and Hernia Surgery, Hwa Mei Hospital, University of Chinese Academy of Science, Ningbo 315010, China
  • Received:2018-12-28 Published:2019-06-18
  • Corresponding author: Yuxuan Mo
引用本文:

王小伟, 卢飞, 刘顶先, 王松伟, 莫宇轩. 单孔腹腔镜下应用硬膜外穿刺针治疗小儿腹股沟斜疝682例[J/OL]. 中华疝和腹壁外科杂志(电子版), 2019, 13(03): 217-220.

Xiaowei Wang, Fei Lu, Dingxian Liu, Songwei Wang, Yuxuan Mo. Single-port mini-laparoscopic treatment with epidural needle for children with indirect hernia: A report of 682 cases[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(03): 217-220.

目的

探讨经脐单孔腹腔镜下应用硬膜外穿刺针联合行疝囊高位结扎治疗小儿腹股沟斜疝的应用价值。

方法

回顾分析2016年2月至2018年7月,安徽阜阳疝病专科医院利用硬膜外穿刺针在单孔腹腔镜下治疗腹股沟疝682例患儿的临床疗效。

结果

682例患儿手术均在单孔腹腔镜下顺利完成,无精索血管或输精管损伤。手术时间:单侧5~12 min,平均8.5 min;双侧10~24 min,平均17 min。术中发现并同时处理对侧隐匿性斜疝75例(13.09%)。术中出血量为0.5~2 ml,平均1 ml。患儿麻醉完全清醒后恢复饮食,并可下床活动。所有患儿均在术后次日上午办理出院。术后及随访期间均未发现并发症及复发病例。

结论

应用硬膜外穿刺针行单孔法腹腔镜高位结扎疝囊治疗小儿斜疝初步结果显示安全有效,操作简便,而且具有创伤小,术后恢复快、不留瘢痕等优点,值得临床开展及推广应用。

Objective

To discuss the clinical value of single-port mini-laparoscopic treatment with epidural needle for children with indirect hernia.

Methods

682 cases of children with indirect inguinal hernia of Fuyang Hospital of Hernia Disease hospital between February 2016 and July 2018 were enrolled in this study. They were treated by high ligation of inguinal hernial sac under single-port mini-laparoscopic surgery with epidural needle and guided suture. To analyze the operation time, blood loss, postoperative complications and recurrence rate for all cases. The clinical data were retrospectively analyzed.

Results

All surgery was successfully completed. Operation time was 8.5 minutes (5 to 12 minutes) in 573 cases of unilateral hernia and 17 minutes (10 to 24 minutes) in 184 cases of bilateral hernia. Bleeding volume during the operation was 0.5 to 2 ml, mean of 1 ml. After a follow-up of 2 to 27 months, no complications and recurrence were presented.

Conclusion

The laparoscopic technique for pediatric indirect inguinal hernia with epidural needle is safe and reliable, with minor invasion and satisfied outcome. It is easy to be learned and performed, which is worth of being generalized.

图1 手术所需要准备的相关器械
图2 单孔腹腔镜下应用硬膜外穿刺针及导丝高位结扎疝囊手术步骤
图3 隐蔽于脐窝脐部伤口的影像资料
[1]
李炳根,聂向阳. 儿童腹股沟疝的腹腔镜手术治疗进展[J]. 中华外科杂志, 2013, 51(4): 328-330.
[2]
李炳根,聂向阳,余国忠, 等. 用大圆针行单孔腹腔镜手术治疗小儿斜疝772例报告[J]. 中华外科杂志, 2011, 49(9): 851-852.
[3]
许波涛,顾晓华,王鑫羊. 微型腹腔镜治疗小儿腹股沟斜疝110例分析[J/CD]. 中华疝和腹壁外科杂志(电子版), 2016, 10(1): 61-62.
[4]
Cui Z, Liu Y, Zhang W, et al. Single-port laparoscopic percutaneous double ligation for pediatric inguinal hernias: report of a new technique and early results[J]. Hernia, 2015, 20(4): 579-584.
[5]
郭伟,李铁军,王佾, 等. 自制穿刺针经脐单孔腹腔镜小儿斜疝全腹膜外疝囊高位结扎术325例报道[J/CD]. 中华疝和腹壁外科杂志(电子版), 2017, 11(3): 189-192.
[6]
Li B, Xie H, Gong D. Modified single-port laparoscopic herniorrhaphy for pediatric inguinal hernias: based on 1, 107 cases in China[J]. Surg Endosc, 2012, 26(12): 3663-3668.
[7]
Li C, Xu L, Peng Y, et al. Effects of single-port laparoscopic percutaneous extraperitoneal closure on the orientation of the vas deferens and testicular perfusion and volume: experience from a single center[J]. J Pediatr Urol, 2016, 12(3): 170. e1-170. e5.
[8]
Sachs M, Damm M, Encke A. Historical evolution of inguinal hernia repair[J]. World J Surg, 1997, 21(2): 218-223.
[9]
Rajput A, Gauderer MWL, Hack M. Inguinal hernias in very low birth weight infants: Incidence and timing of repair[J]. J Pediatr Surg, 1992, 27(10): 1322.
[10]
Walsh SZ. The incidence of external hernias in premature infants[J]. Acta Paediatr, 2010, 51(2): 161-164.
[11]
Hadžiselimović F. Embryology of testicular descent and maldescent [M]//Cryptorchidism. Springer Berlin Heidelberg, 1983.
[12]
佘亚雄. 小儿外科学[M]. 北京: 人民卫生出版社, 1997.
[13]
Hassan ME, Mustafawi AR. Laparoscopic flip-flap technique versus conventional inguinal hernia repair in children[J]. JSLS, 2007, 11(1): 90-93.
[14]
Shalaby R, Shams AM, Mohamed S, et al. Two-trocar needlescopic approach to incarcerated inguinal hernia in children[J]. J Pediatr Surg, 2007, 42(7): 1259-1262.
[15]
García-Hernández C, Carvajal-Figueroa L, Suarez-Gutiérrez R, et al. Laparoscopic approach for inguinal hernia in children: resection without suture[J]. J Pediatr Surg, 2012, 47(11): 2093-2095.
[16]
唐剑平,何东北,唐向东, 等. 腹腔镜下小儿腹股沟斜疝高位结扎术45例[J]. 临床小儿外科杂志, 2007, 6(1): 48-49.
[17]
朱彩荣,聂向阳,方锦标, 等. 一孔法腹腔镜小儿腹股沟斜疝高位结扎术的疗效评价[J]. 中华普通外科杂志, 2009, 24(2): 160-161.
[18]
龚独辉,李炳根,莫宇轩, 等. 单孔腹腔镜下大圆针体外二次缝合法治疗小儿腹股沟斜疝的疗效分析[J/CD]. 中华疝和腹壁外科杂志(电子版), 2018, 12(1): 26-29.
[19]
Patkowski D, Czernik J, Chrzan R, et al. Percutaneous internal ring suturing: a simple minimally invasive technique for inguinal hernia repair in children[J]. J Laparoendosc Adv Surg Tech A, 2006, 16(5): 513-517.
[20]
李萌,李索林,于增文, 等. 单孔腹腔镜下改良双钩疝针经皮腹膜外结扎术治疗小儿腹股沟疝[J]. 中华小儿外科杂志, 2012, 33(12): 916-919.
[21]
雷泽华,高峰畏,包平倩, 等. 腹腔内疝囊充填关闭术治疗小儿斜疝[J]. 中华小儿外科杂志, 2014, 35(5): 358-361.
[1] 李国新, 陈新华. 全腹腔镜下全胃切除术食管空肠吻合的临床研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 1-4.
[2] 李子禹, 卢信星, 李双喜, 陕飞. 食管胃结合部腺癌腹腔镜手术重建方式的选择[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 5-8.
[3] 李乐平, 张荣华, 商亮. 腹腔镜食管胃结合部腺癌根治淋巴结清扫策略[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 9-12.
[4] 陈方鹏, 杨大伟, 金从稳. 腹腔镜近端胃癌切除术联合改良食管胃吻合术重建His角对术后反流性食管炎的效果研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 15-18.
[5] 许杰, 李亚俊, 韩军伟. 两种入路下腹腔镜根治性全胃切除术治疗超重胃癌的效果比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 19-22.
[6] 李刘庆, 陈小翔, 吕成余. 全腹腔镜与腹腔镜辅助远端胃癌根治术治疗进展期胃癌的近中期随访比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 23-26.
[7] 任佳, 马胜辉, 王馨, 石秀霞, 蔡淑云. 腹腔镜全胃切除、间置空肠代胃术的临床观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 31-34.
[8] 赵丽霞, 王春霞, 陈一锋, 胡东平, 张维胜, 王涛, 张洪来. 内脏型肥胖对腹腔镜直肠癌根治术后早期并发症的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 35-39.
[9] 李博, 贾蓬勃, 李栋, 李小庆. ERCP与LCBDE治疗胆总管结石继发急性重症胆管炎的效果[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 60-63.
[10] 王庆亮, 党兮, 师凯, 刘波. 腹腔镜联合胆道子镜经胆囊管胆总管探查取石术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 313-313.
[11] 杨建辉, 段文斌, 马忠志, 卿宇豪. 腹腔镜下脾部分切除术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 314-314.
[12] 叶劲松, 刘驳强, 柳胜君, 吴浩然. 腹腔镜肝Ⅶ+Ⅷ段背侧段切除[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 315-315.
[13] 郭兵, 王万里, 何凯, 黄汉生. 腹腔镜下肝门部胆管癌根治术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 143-143.
[14] 李凯, 陈淋, 苏怀东, 向涵, 张伟. 超微创器械在改良单孔腹腔镜巨大肝囊肿开窗引流及胆囊切除中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 144-144.
[15] 魏丽霞, 张安澜, 周宝勇, 李明. 腹腔镜下Ⅲb型肝门部胆管癌根治术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 145-145.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?