[1]陈盛 严志龙** 陈其民.单切口腹腔镜治疗儿童复发性腹股沟疝[J].中国微创外科杂志,2017,17(3):231-233.
 Chen Sheng,Yan Zhilong,Chen Qimin..Single-incision Laparoscopy for Recurrent Inguinal Hernia in Children[J].Chinese Journal of Minimally Invasive Surgery,2017,17(3):231-233.
点击复制

单切口腹腔镜治疗儿童复发性腹股沟疝()
分享到:

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年3期
页码:
231-233
栏目:
临床研究
出版日期:
2017-06-20

文章信息/Info

Title:
Single-incision Laparoscopy for Recurrent Inguinal Hernia in Children
作者:
陈盛 严志龙** 陈其民
上海交通大学医学院附属上海儿童医学中心普外科,上海200127
Author(s):
Chen Sheng Yan Zhilong Chen Qimin.
Department of General Surgery, Shanghai Children’s Medical Center, School of Medicine of Shanghai Jiaotong University, Shanghai 200127, China
关键词:
腹股沟复发腹腔镜儿童
Keywords:
HerniaInguinalRecurrenceLaparoscopyChildren
文献标志码:
A
摘要:
目的探讨单切口腹腔镜疝囊高位结扎术在儿童复发性腹股沟疝中的应用价值。方法回顾性分析2011年1月~2016年2月我院单切口腹腔镜治疗30例儿童复发性腹股沟疝的临床资料。年龄1~11岁,(6.1±3.3)岁。对斜疝采用腹腔镜下带线针、钩针配合,内环口腹膜外潜行置线、荷包结扎的方法高位结扎疝囊;对直疝用类似方法结扎疝囊,同时将脐动脉襞缝合覆盖于直疝三角,起到加固作用。结果术中证实28例为斜疝复发,其中4例对侧存在隐匿性斜疝;2例为直疝。手术时间12~45 min,(21.4±8.2)min。30例随访2~53个月,(23.9±12.5)月,均无再次复发。术后瘢痕隐蔽,无并发症。结论单切口腹腔镜治疗儿童复发性腹股沟疝安全有效,瘢痕隐蔽,并可术中诊断处理隐匿性疝、直疝。
Abstract:
ObjectiveTo investigate the clinical value of single-incision laparoscopic inguinal high ligation in children with recurrent inguinal hernia. MethodsClinical data of 30 pediatric recurrent inguinal hernia cases treated with single-incision laparoscopy in our hospital between January 2011 and February 2016 were analyzed retrospectively. The patients were aged 1-11 years old (mean, 6.1±3.3 years old). For indirect inguinal hernia, a non-absorbable suture was placed around the extra-peritoneal space of the inguinal inner ring by means of a needle with a thread hole and a hooked needle under laparoscope, and the hernial sac was highly ligated by knotting the purse string suture. If a direct inguinal hernia was identified, a similar method was used to ligate the hernial sac, and the umbilical artery fold was sutured to the Hesselbach’s triangle in order to enhance the weak tissue.ResultsAfter surgeries, we found 28 cases were recurrent indirect inguinal hernia (4 cases with contralateral concealed hernia), and the other 2 cases were direct inguinal hernia. The operation time ranged from 12 to 45 min (mean, 21.4±8.2 min). All th cases recovered with inconspicuous scars, and no recurrence or complications were found during a follow-up for 2-53 months (mean, 23.9±12.5 months).ConclusionsSingle-incision laparoscopic inguinal high ligation is a safe and effective procedure for children with recurrent inguinal hernia. This procedure does not cause obvious scars for patients, and can diagnose and treat the occult hernia and direct hernia at the same time.

参考文献/References:

[1]Burgmeier C,Dreyhaupt J,Schier F.Gender-related differences of inguinal hernia and asymptomatic patent processus vaginalis in term and preterm infants.J Pediatr Surg,2015,50(3):478-480.
[2]杨庆堂,姚干,梁健升,等.微型腹腔镜治疗小儿腹股沟直疝四例报告.中华小儿外科杂志,2013,34(3):234-235.
[3]朱伟超,何建华.小儿腹股沟直疝的诊断与治疗.中华小儿外科杂志,2013,34(3):227-229.
[4]张冬,黄永.腹腔镜下内外环联合修补术治疗小儿复发疝163例报道.中国普外基础与临床杂志,2012,19(12):1344-1346.
[5]丁善衡.小儿腹股沟斜疝术后复发因素探究.中国全科医学,2012,15(3):304-305.
[6]Treef W,Schier F.Characteristics of laparoscopic inguinal hernia recurrences.Pediatr Surg Int,2009,25(2):149-152.
[7]Shalaby R,Ismail M,Gouda S,et al.Laparoscopic management of recurrent inguinal hernia in childhood.J Pediatr Surg,2015,50(11):1903-1908.
[8]肖乾虎.腹股沟疝的围手术期处理.中华疝和腹壁外科杂志(电子版),2009,3(1):1-8.
[9]胡明,严志龙.经脐单切口腹腔镜下儿童腹股沟疝高位结扎术.中国微创外科杂志,2012,12(10):912-916.
[10]姚明军,李邦民,阮兴举,等.小儿复发疝腹腔镜手术29例临床分析.腹腔镜外科杂志,2012,17(4):294,304.
[11]李云鹤,王翠娥,孔凡明.腹腔镜治疗小儿复发性斜疝的体会.腹腔镜外科杂志,2005,10(1):29-30.
[12]郑向欣,管小青,吴骥,等.腹腔镜下带线气腹针治疗小儿腹股沟斜疝的应用价值.中国普外基础与临床杂志,2015,22(4):468-471.
[13]夏东亮,张丽华,李庆浩,等.单孔腹腔镜和雪橇针治疗儿童腹股沟斜疝手术经验与技巧.中华疝和腹壁外科杂志(电子版),2014,8(3):265-270.
[14]Esposito C,Alicchio F,Giurin I,et al.Technical standardization of laparoscopic direct hernia repair in pediatric patients.J Laparoendosc Adv Surg Tech A,2012,22(1):113-116.

备注/Memo

备注/Memo:
基金项目:上海自然科学基金(面上)项目(13ZR1426300)**通讯作者,E-mail:dryanzhilong@163.com
更新日期/Last Update: 2017-06-20