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中华疝和腹壁外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (01) : 83 -86. doi: 10.3877/cma.j.issn.1674-392X.2022.01.019

临床论著

腹腔镜手术治疗小儿腹股沟疝的并发症分析
杨坤1, 李杨1, 黄曈1, 吉磊1, 祝维1, 龚光伟1,()   
  1. 1. 432000 武汉科技大学附属孝感医院普通外科Ⅱ(胃肠/小儿外科)
  • 收稿日期:2019-09-10 出版日期:2022-02-18
  • 通信作者: 龚光伟

Analysis of complications and its prevention of laparoscopic treatment of inguinal hernia in children

Kun Yang1, Yang Li1, Tong Huang1, Lei Ji1, Wei Zhu1, Guangwei Gong1,()   

  1. 1. Department of general surgery Ⅱ (Gastrointestinal Surgery/Pediatric Surgery), Xiaogan Hospital Affiliated to Wuhan University of Science and Technology, Xiaogan 432000, Hubei province, China
  • Received:2019-09-10 Published:2022-02-18
  • Corresponding author: Guangwei Gong
引用本文:

杨坤, 李杨, 黄曈, 吉磊, 祝维, 龚光伟. 腹腔镜手术治疗小儿腹股沟疝的并发症分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2022, 16(01): 83-86.

Kun Yang, Yang Li, Tong Huang, Lei Ji, Wei Zhu, Guangwei Gong. Analysis of complications and its prevention of laparoscopic treatment of inguinal hernia in children[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(01): 83-86.

目的

探讨腹腔镜手术治疗小儿腹股沟疝的术后并发症及防治对策。

方法

回顾性分析2015年1月至2019年1月于武汉科技大学附属孝感医院收治的1040例小儿腹股沟疝患者资料。所有患儿均在全身麻醉下采用疝钩针行腹腔镜下疝囊高位结扎术,术后门诊及电话随访患儿术后并发症,总结分析并提出防治策略。

结果

所有患儿腹腔镜手术均成功完成。术后腹股沟区皮下硬结23例,予以观察后好转。5例并发鞘膜积液,其中3例行穿刺抽吸观察后吸收,2例穿刺抽吸无效后再次手术;3例术后复发,再次手术。线头反应3例,其中2例线头排出后恢复,1例线头排出后复发,再次手术。脐部出血2例,其中1例压迫后缓解,1例压迫无效行切口缝合止血。脐部网膜脱出2例,行脱出网膜切除脐部缝合。手术并发症多发生在早期开展病例中,通过改进手术方式及细节,后期并发症减少。

结论

腹腔镜治疗小儿腹股沟疝的术后并发症以皮下硬结、术后鞘膜积液及脐部穿刺处并发症较多,通过改进手术方式及细节,均可避免。

Objective

To investigate the complications and its prevention of laparoscopic surgery in the treatment of inguinal hernia in children.

Methods

From January 2015 to January 2019, 1040 children with inguinal hernia were admitted to Xiaogan Hospital, which is affiliated with Wuhan University of Science and Technology. All children underwent laparoscopic high ligation of the hernia sac under general anesthesia with a hernia hook needle. Postoperative outpatient and telephone follow-up of the children were followed up for postoperative complications, and the prevention and treatment strategies were summarized and analyzed.

Results

Laparoscopic surgery was successfully completed in all children. Among the complications, 23 cases were indurated under the skin of the inguinal region; 5 cases were complicated with hydrocele after operation, 3 cases were absorbed after pumping the liquid, 2 cases were operated again after ineffective pumping; 3 cases had recurrence and reoperation again; 3 cases were treated with line head reaction, 2 cases recovered after line head excretion, 1 case was reoperation again; 2 cases were treated with umbilical hemorrhage, 1 case was relieved after compression, 1 case was sutured with incision suture to stop bleeding; 2 cases were treated with prolapse of omentum in the umbilical, and 2 cases were sutured with removal of omentum. Surgical complications mostly occur in early-stage cases, and later complications can be reduced by improving surgical methods and details.

Conclusion

Subcutaneous induration, postoperative hydrocele, and umbilical puncture are more common postoperative complications of laparoscopic treatment of inguinal hernia in children, which can be avoided by improving surgical methods and details.

图1 腹腔镜手术示意图注:1A男性患儿经脐部两孔法;1B男性患儿术后腹部外观;1C女性患儿经脐部单孔法;1D女性患儿术后腹部外观
图2 左侧为2017年前使用疝针,右侧为2017年后使用的双钩注水疝针
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