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中华疝和腹壁外科杂志(电子版)

中华疝和腹壁外科杂志(电子版) ›› 2020, Vol. 14 ›› Issue (06) : 601 -604. doi: 10.3877/cma.j.issn.1674-392X.2020.06.004

所属专题： 文献；

临床论著

腹腔镜经脐双孔治疗小儿腹股沟斜疝的疗效
苏鹏超1,†(), 耿伟民1, 刘昆强1, 刘宁1   
  1. 1. 101100　北京市通州区妇幼保健院小儿外科
  • 收稿日期:2019-08-03 出版日期:2020-12-20
  • 通信作者: 苏鹏超
  • 基金资助:
    国家科技支撑计划(2014BAI10B00)

Outcomes of trans-umbilical two-port laparoscopic procedure for treatment of indirect inguinal hernia in children

Pengchao Su1,†(), Weimin Geng1, Kunqiang Liu1, Ning Liu1   

  1. 1. Pediatric Surgery, Maternal and Child Health Hospital of Tongzhou District, Beijing 101100, China
  • Received:2019-08-03 Published:2020-12-20
  • Corresponding author: Pengchao Su
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引用本文：

苏鹏超, 耿伟民, 刘昆强, 刘宁. 腹腔镜经脐双孔治疗小儿腹股沟斜疝的疗效[J]. 中华疝和腹壁外科杂志(电子版), 2020, 14(06): 601-604.

Pengchao Su, Weimin Geng, Kunqiang Liu, Ning Liu. Outcomes of trans-umbilical two-port laparoscopic procedure for treatment of indirect inguinal hernia in children[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2020, 14(06): 601-604.

目的

观察采用经脐双孔法腹腔镜治疗小儿腹股沟斜疝的手术效果。

方法

回顾分析2018年1~12月北京市通州区妇幼保健院154例经脐双孔法腹腔镜治疗小儿腹股沟斜疝临床资料，评估经脐双孔法腹腔镜治疗腹股沟斜疝临床疗效。

结果

所有患儿顺利完成手术，其中单侧腹股沟斜疝71例（46.1%），双侧腹股沟斜疝6例（3.8%），术中发现对侧隐匿疝77例（50%），单侧腹股沟斜疝平均手术时间（32.7±10.1）min，双侧腹股沟斜疝平均手术时间（33.4±10.9）min。术后随访6个月，未发现复发、阴囊血肿、睾丸萎缩及脐疝等相关并发症。

结论

经脐双孔法腹腔镜治疗小儿腹股沟斜疝疗效确切，术后瘢痕小，术后并发症低。

关键词: 腹股沟斜疝, 腹腔镜, 儿童, 经脐双孔法
Objective

To observe the effect of laparoscopic trans-umbilical two-port laparoscopic procedure for treatment of indirect inguinal hernia in children.

Methods

The clinical data of 154 cases of indirect inguinal hernia in children from Tongzhou district maternal and child health hospital were analyzed retrospectively to evaluate the clinical effect of trans-umbilical two-port laparoscopic treatment of indirect inguinal hernia.

Results

All the children successfully completed the operation, including 71 cases (46.1%) of unilateral indirect inguinal hernia, 6 cases (3.8%) of bilateral indirect inguinal hernia, 77 cases (50%) of contralateral occult hernia were found during the operation. The average operation time of unilateral indirect inguinal hernia was (32.7±10.1) minutes, and that of bilateral indirect inguinal hernia was (33.4±10.9) minutes. The postoperative follow-up was 6 months, and no recurrence, scrotal hematoma, testicular atrophy, umbilical hernia and other related complications were found.

Conclusion

Trans-umbilical two-port laparoscopic treatment of indirect inguinal hernia in children is effective, with small scar and low postoperative complications rate.

Key words: Laparoscope, Children, Indirect inguinal hernia, Trans-umbilicus, Two-port
表1 154例腹股沟斜疝患儿的临床资料（例）
临床资料 例数
性别(男/女) 114/40
手术年龄(个月) 6~132(24)
术前斜疝位置(单/双侧) 148(左57/右91)/6
早产史(足月/早产) 142/12
家族史(无/有) 139/15
发现方式(自行/体检) 145/9
嵌顿疝史(无/有) 127/27
嵌顿疝 3
巨大疝 8
[1]
Peng Y, Li C, Han Z, et al. Modified single-port vs two-port laparoscopic herniorrhaphy for children with concealed deferent duct: a retrospective study from a single institution[J]. Hernia, 2016, 21(3): 435-441.
[2]
吴玲玲，移康，田金徽, 等. 儿童腹股沟疝腹腔镜术与开放性手术疗效和安全性的Meta分析[J]. 中国循证儿科杂志, 2010, 4(5): 299-303.
[3]
赵易丹. 儿童腹股沟斜疝腹腔镜修补术后的线结反应[J]. 临床小儿外科杂志, 2017, 3(16): 288-291.
[4]
崔钊，鲁莹，李秋琳等. 单孔腹腔镜治疗儿童巨大腹股沟斜疝[J]. 中国微创外科杂志, 2018, 18(9): 799-801.
[5]
杨周健，刘钧，唐青松, 等. 腹腔镜手术治疗新生儿腹股沟斜疝的临床疗效分析[J]. 腹腔镜外科杂志, 2018, 23(8): 621-624.
[6]
李索林，刘琳，杨晓锋. 腹腔镜技术诊治小儿腹股沟斜疝的现状与评价[J]. 中华小儿外科杂志, 2014, 35(6): 406-409.
[7]
Koivusalo AI, Korpela R, Wirtavuori K, et al. A single-blinded, randomized comparison of laparoscopic versus open hernia repair in children. Pediatrics2009, 123(1): 332-337.
[8]
Wang F, Zhong H, Chen Y, et al. Single-site laparoscopic percutaneous extraperitoneal closure of the internal ring using an epidural and spinal needle: excellent results in 1464 children with inguinal hernia/hydrocele. Surg Endosc2017, 31(7): 2932-2938.
[9]
Ismail M, Shalaby R. Single instrument intracorporeal knot tying during single port laparoscopic hernia repair in children: a new simplified technique. J pediatr Surg, 2014, 49(6): 1044-1048.
[10]
周立军，李功俊，沈刚, 等. 两种经脐单孔腹腔镜手术治疗小儿腹股沟斜疝的对比研究[J]. 腹腔镜外科杂志, 2017, 9(22): 696-699.
[11]
刘强，董昆，杨体泉, 等. 腹腔镜下缝合法与疝针法疝囊高位结扎术的疗效[J]. 临床小儿外科, 2012, 1(11): 41-44.
[12]
胡晓立，刘坚，尹同治. 腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝的疗效观察[J]. 微创医学, 2016, 5(11): 708-709.
[13]
赵易丹，沈桢，宋再，孙松，陈功，郑珊. 儿童腹股沟斜疝修补术后线结反应的危险因素分析[J]. 临床小儿外科杂志, 2019, 18(1): 49-53.
[14]
Bhatia AM, Gow KW, Heiss KF, et al. Is the use of laparoscopy to determine presence of contralateral patent processus vaginalis justified in children greater than 2 years of age?[J]. Pediatr Surg, 2004, 39(5): 778-781.
[15]
奉有才，陈家蓉，李新宁, 等. 改良经脐双孔法腹腔镜治疗小儿腹股沟斜疝的临床效果[J]. 广西医学, 2019, 41(7): 905-906.
[16]
王新星，李帅，汤绍涛, 等. 单纯经脐腹腔镜下疝囊高位结扎术治疗小儿腹股沟斜疝[J]. 临床小儿外科杂志, 2016, 15(4): 348-350.
[17]
Jun Z, Juntao G, Shuli L, et al. A comparative study on trans-umbilical single-port laparoscopic approach versus conventional repair for incarcerated inguinal hernia in children[J]. J Mini Access Surg, 2016, 12(2): 139-142.
[18]
Naruhiko Murase, Hiroo Uchida, Takashi Seki A. Feasibility of single-incision laparoscopic percutaneous extraperitoneal closure for treatment of incarcerated inguinal hernia in children: our preliminary outcome and review of the literature[J]. Nagoya J Med, 2016, 78: 19-25.
[19]
Esposito C, Escolino M, Cortese G, et al. Twenty-year experience with laparoscopic inguinal hernia repair in infants and children: considerations and results on 1833 hernia repairs[J]. Surg Endosc, 2016, 31(3): 1461-1468.
[20]
Bharathi RS, Arora M, Baskaran V. How we" SEAL" internal ring in pediatric inguinal hernias[J]. Surg Lap Endose Percut Tech, 2008, 18(2): 192-194.
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