[1]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.
　Cui Zhao,Lu Ying,Li Qiulin,et al.Therapeutic Efficacy Observation for Single-port Laparoscopic Surgery on Children’s Huge Indirect Inguinal Hernia[J].Chinese Journal of Minimally Invasive Surgery,2018,18(9):799-801.
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单孔腹腔镜治疗儿童巨大腹股沟斜疝()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
18
期数:
2018年9期
页码:
799-801
栏目:
临床研究
出版日期:
2018-12-06

文章信息/Info

Title:
Therapeutic Efficacy Observation for Single-port Laparoscopic Surgery on Children’s Huge Indirect Inguinal Hernia
作者:
崔钊; 鲁莹; 李秋琳; 周垂兵; 刘雪来*①
长春市儿童医院外科，长春130000
Author(s):
Cui Zhao;  Lu Ying;  Li Qiulin;  et al.
Department of Surgery, Changchun Children Hospital, Changchun 130000, China
关键词:
腹股沟斜疝; 巨大; 单孔腹腔镜; 双钩疝针; 内环结扎; 脐内侧襞
Keywords:
Indirect inguinal hernia; Huge; Single-port laparoscopic surgery; Two-hooked core needle; Internal ring closure; Medial umbilical fold
文献标志码:
A
摘要:
目的探讨单孔腹腔镜辅助腹膜外双钩疝针内环关闭并脐内侧襞遮盖术治疗儿童巨大（内环口直径≥1.5 cm）腹股沟斜疝的近期疗效。方法回顾长春市儿童医院2015年1月~2017年5月单孔腹腔镜辅助腹膜外水分离双钩套扎针内环口闭合并脐内侧襞遮盖修补术治疗的63例巨大疝资料。均为男性，年龄5个月~6岁，中位年龄36个月，疝内环口直径≥1.5 cm，实施单孔腹腔镜辅助腹膜外双钩疝针疝内环关闭并脐内侧襞遮盖。结果63例（77侧）巨大腹股沟疝均成功实施手术。49例单侧巨大疝术中发现32例合并对侧鞘状突未闭，予以同时单纯腹膜外内环结扎。手术时间单侧49例为（9.5±3.5）min，双侧14例为（20.8±4.2）min。术中未出现血管损伤、疝环腹膜撕裂及腹膜结扎不全等。随访时间6~30个月，平均22个月。2例鞘膜积液，2例线结反应，无伤口感染、复发疝以及医源性隐睾或睾丸萎缩等并发症发生。结论单孔腹腔镜辅助腹膜外双钩疝针内环关闭并脐内侧襞遮盖术治疗儿童巨大腹股沟斜疝安全、有效。
Abstract:
ObjectiveTo investigate the short-term therapeutic efficacy of single-port laparoscopic internal ring closure plusipsilateral medial umbilical fold flap (MUFF) cover using a two-hooked core needle on children’s huge indirect inguinal hernia (diameter of inner ring orifice ≥ 1.5 cm).MethodsA total of 63 cases of huge inguinal hernias between January 2015 and May 2017 underwent laparoscopic percutaneous extraperitoneal closure (LPEC) and followed by MUFF reinforcement in our hospital. All the patients were male, aged between 5 months-6 years old, with a median age of 36 months. The inner ring orifice was more than 15 cm. All of them underwent LPEC plus MUFF reinforcement.ResultsThe LPEC plus MUFF reinforcement was successfully completed in 63 cases (77 sides). Among 49 cases of unilateral huge hernia, 32 cases were found to complicate with contralateral patent processus vaginalis and LPEC procedure was performed. The mean operating time for unilateral(49 cases) and bilateral (14 cases) repairs was (9.5±3.5) min and (20.8±4.2) min, respectively. There were no vessel injury, tearing of peritoneum or incomplete peritoneal ligation during operation. The follow-up time was 6-30 months (mean, 22 months). Two cases were found to present hydrocele and another two cases were seen to have clot-induced foreign body reaction. No wound infection, recurrence, iatrogenic cryptorchidism or testicular atrophy was noted postoperatively in this study.ConclusionsSingle-port LPEC plus MUFF reinforcement using a two-hooked core needle is safe and handy. It is a worthy option in the treatment of pediatric huge indirect inguinal hernia with satisfactory therapeutic efficacy.

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备注/Memo

备注/Memo:
*通讯作者，E-mail：liuxuelai_steven@163.com①（河北医科大学第二医院小儿外科，石家庄050000）
更新日期/Last Update: 2018-12-06