单孔双针疝囊高位结扎术在儿童巨大腹股沟疝的临床应用

doi:10.3877/cma.j.issn.1674-392X.2023.05.014

中华疝和腹壁外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (05) : 566 -569. doi: 10.3877/cma.j.issn.1674-392X.2023.05.014

论著

单孔双针疝囊高位结扎术在儿童巨大腹股沟疝的临床应用

彭永辉, 张文杰, 李炳根, 聂向阳, 吴凯, 杨六成^†(

)

510282　广州，南方医科大学珠江医院小儿外科；511400　广州市番禺区何贤纪念医院肝胆疝外科
511400　广州市番禺区何贤纪念医院肝胆疝外科
510282　广州，南方医科大学珠江医院小儿外科

收稿日期:2023-03-29 出版日期:2023-10-18
通信作者: 杨六成
基金资助:
广东省自然科学基金(2019A1515011086)

Clinical application of high ligation of single hole and double needle hernia sac in giant inguinal hernia in children

Yonghui Peng, Wenjie Zhang, Binggen Li, Xiangyang Nie, Kai Wu, Liucheng Yang^†()

Department of Pediatric Surgery, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China; Surgery of Hepatobiliary Hernia, Hexian Memorial Hospital of Panyu, Guangzhou 511400, China
Surgery of Hepatobiliary Hernia, Hexian Memorial Hospital of Panyu, Guangzhou 511400, China
Department of Pediatric Surgery, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China

Received:2023-03-29 Published:2023-10-18
Corresponding author: Liucheng Yang

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引用本文：

彭永辉, 张文杰, 李炳根, 聂向阳, 吴凯, 杨六成. 单孔双针疝囊高位结扎术在儿童巨大腹股沟疝的临床应用[J/OL]. 中华疝和腹壁外科杂志(电子版), 2023, 17(05): 566-569.

Yonghui Peng, Wenjie Zhang, Binggen Li, Xiangyang Nie, Kai Wu, Liucheng Yang. Clinical application of high ligation of single hole and double needle hernia sac in giant inguinal hernia in children[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(05): 566-569.

目的

探讨单孔双针疝囊高位结扎术治疗儿童巨大腹股沟疝的临床效果。

方法

回顾性分析自2003年1月至2023年1月广州市番禺区何贤纪念医院应用单孔双针疝囊高位结扎术治疗36例巨大腹股沟斜疝患儿的临床资料，观察其手术时间、术中出血量、伤口疼痛情况、并发症发生率及复发率。

结果

36例患儿均成功施行单孔双针疝囊高位结扎术。单侧疝手术时间平均10 min，双侧疝手术时间平均12 min。术中平均出血1 ml，术后手术切口疼痛轻微，男性患儿未发生阴囊气肿、血清肿。所有患儿纳入日间手术流程管理，术后随访6~60个月并定期超声检查未见阴囊积液，睾丸血运正常，未见萎缩，无复发病例。

结论

单孔双针疝囊高位结扎术在儿童巨大腹股沟疝治疗中安全、可靠，并发症发生率低，复发率低。

关键词: 腹股沟斜疝, 儿童, 腹腔镜, 高位结扎, 巨大疝, 安全性

Objective

To investigate the clinical effect of high ligation of single hole and double needle hernia sacs in the treatment of giant inguinal hernia in children.

Methods

From January 2003 to January 2023, 36 children with giant oblique inguinal hernias were treated with high ligation of single hole and double needle hernia sacs. The clinical data of these patients were retrospectively analyzed. The operative time, intraoperative blood loss, wound pain, complication rate and recurrence rate were observed.

Results

High ligation of the hernia sac with a single hole and double needle was performed successfully in all 36 cases. The average operation time of unilateral hernia was 10 min, and that for bilateral hernia was 12 min. The average intraoperative bleeding was 1 ml, and postoperative incision pain was slight. No scrotal emphysema or seroma occurred in the male child. All the children were included in the management of the day operation procedure, and no recurrence was reported after 6-60 months of follow-up. Regular B-ultrasound examinations showed no scrotal effusion, normal testicular blood flow, no atrophy, and no recurrent cases.

Conclusion

High ligation of single hole and double needle hernia sacs is safe and reliable in the treatment of giant inguinal hernia in children, with a low complication rate and recurrence rate.

Key words: Hernia, inguinal, Children, Laparoscopy, High ligation, Giant hernia, Security

图1 手术所用Endoclose腹壁筋膜缝合器和弧形针

图2 单孔双针法儿童巨大疝高位结扎过程注：2A巨大的内环口；2B疝囊高位结扎后。

图3 儿童巨大腹股沟疝手术前后对比注：3A手术前疝囊巨大；3B手术后两侧阴囊对称，皮肤切口较小。

表1 超声测量睾丸体积比较（ml，±s）

组别	例数	治疗前	术后5年	t	P
手术患儿	36	0.431±0.006	0.430±0.005	0.204	0.84
无手术患儿	36	0.428±0.004	0.427±0.003	0.329	0.745
t		1.647	1.725
P		0.111	0.096

表1 超声测量睾丸体积比较（ml，±s）

组别	例数	治疗前	术后5年	t	P
手术患儿	36	0.431±0.006	0.430±0.005	0.204	0.84
无手术患儿	36	0.428±0.004	0.427±0.003	0.329	0.745
t		1.647	1.725
P		0.111	0.096

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