[1]康延杰* 刘海潮① 孙建涛.自制水分离疝针在腹腔镜鞘状突高位结扎术中的应用[J].中国微创外科杂志,2021,01(1):27-30.
 Kang Yanjie*,Liu Haichao,Sun Jiantao*..Application of Selfmade Water Separation Hernia Needle in Laparoscopic High Ligation of Processus Vaginalis[J].Chinese Journal of Minimally Invasive Surgery,2021,01(1):27-30.
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自制水分离疝针在腹腔镜鞘状突高位结扎术中的应用()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2021年1期
页码:
27-30
栏目:
临床研究
出版日期:
2021-02-26

文章信息/Info

Title:
Application of Selfmade Water Separation Hernia Needle in Laparoscopic High Ligation of Processus Vaginalis
作者:
康延杰* 刘海潮① 孙建涛
(郑州大学附属洛阳中心医院泌尿外科,洛阳471000)
Author(s):
Kang Yanjie* Liu Haichao Sun Jiantao*.
*Department of Urology, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang 471000, China
关键词:
交通性鞘膜积液腹股沟斜疝腹腔镜水分离鞘状突
Keywords:
Communicating hydroceleIndirect inguinal herniaLaparoscopyHydrodissectionProcessus vaginalis
文献标志码:
A
摘要:
目的探讨自制水分离疝针腹腔镜鞘状突高位结扎术的疗效。方法2018年4月~2019年4月我院行腹腔镜鞘状突高位结扎术121例,其中59例行腹腔镜一步穿刺法自制疝针鞘状突结扎术(观察组),62例行腹腔镜传统两步穿刺法鞘状突结扎术(对照组),对比2组患者手术时间、术中出血量、术后住院时间、复发及并发症发生情况。结果所有手术均获成功。与对照组相比,观察组中位手术时间更短[8(6,9)min vs. 12(11,13)min,Z=-7.319,P=0.000],中位术中出血量更少[1(1,2)ml vs. 2(1,2)ml,Z=-4.656,P=0.000]。2 组中位术后住院时间分别为1(1,1)、1(1,1)d,差异无统计学意义(Z=-0.436,P=0.663)。2组并发症分别为1、3例,差异无统计学意义(χ2=0.210,P=0.647)。除观察组1例(术后第1天B超复查鞘膜囊仍有明显积液)随访12个月外,余120例患儿术后随访6个月,所有患儿均无复发。结论自制水分离疝针腹腔镜鞘状突高位结扎术具有单次腹壁穿刺、注水分离腹膜的优点,安全有效,基层医院均可开展,值得推广。
Abstract:
ObjectiveTo explore the therapeutic effect of laparoscopic high ligation of processus vaginalis with selfmade water separation hernia needle.MethodsFrom April 2018 to April 2019, 121 cases of laparoscopic high ligation of processus vaginalis were performed in our hospital. Among them, 59 cases underwent laparoscopic ligation of processus vaginalis by a single step puncture with selfmade hernia needle (observation group), and 62 cases underwent traditional laparoscopic ligation of processus vaginalis by twostep puncture (control group). The operative time, intraoperative blood loss, postoperative hospital stay, recurrence and complications were compared between the two groups.ResultsAll operations were successful. Compared with the control group, the median operative time in the observation group was shorter [8 (6,9) min vs. 12 (11,13) min,Z=-7.319,P=0000],and the median intraoperative blood loss was less [1 (1,2) ml vs. 2 (1,2) ml,Z=-4.656,P=0.000]. The median postoperative hospital stay in the two groups was 1 (1,1) and 1 (1,1) d, respectively, with no significant difference (Z=-0.436, P=0.663). There was 1 complication in each group, and the difference was not significant (χ2=0.210, P=0.647). In the observation group, 1 case was followed up for 12 months, and the remaining 120 cases were followed up for 6 months after surgery. None of the children had recurrence.ConclusionsLaparoscopic high ligation of processus vaginalis with selfmade water separation hernia needle has features of single abdominal wall puncture and separation of peritoneum by water injection. It is safe and effective, and can be carried out in primary hospitals. It is worthy of promotion.

参考文献/References:

[1]中华医学会男科学分会.中国男科疾病诊断治疗指南与专家共识(2016版).北京:人民卫生出版社,2016.99.
[2]刘必银,江平,王崇高,等.自制单孔多通道装置在腹腔镜手术中的应用.临床外科杂志,2017,25(11):870-871.
[3]那彦群,主编.中国泌尿外科疾病诊疗指南.北京:人民卫生出版社,2013.610.
[4]Koski ME, Makari JH, Adams MC, et al. Infant communicating hydroceledo they need immediate repair or might some clinically resolve? J Pediatr Surg,2010,45(3):590-593.
[5]黄澄如,主编.实用小儿泌尿外科学.北京:人民卫生出版社,2006.394-397.
[6]Lee S, Illei PB, Han JS, et al. Florid mesothelial hyperplasia of the tunica vaginalis mimicking malignant mesothelioma: a clinicopathologie study of 12 cases. Am J Surg Pathol,2014,38(1):54-59.
[7]张殷,王忠荣.不同操作通道下腹腔镜经皮腹膜外环扎术治疗儿童鞘膜积液——两中心950例经验总结.临床小儿外科杂志,2017,16(1):54-59.
[8]杨勇,李燕琴.单孔腹腔镜与开放手术治疗小儿鞘状突未闭的疗效比较.现代泌尿外科杂志,2017,22(1):41-43.
[9]朱琳琳,徐伟珏,刘江斌,等.儿童腹腔镜疝囊高位结扎术与传统疝囊高位结扎术的疗效对比分析.中华小儿外科杂志,2019,40(2):122-126.
[10]Tam YH, Lee KH, Sihoe JD, et al. Laparoscopic hernia repair in children by the hook method:A singlecenter series of 433 consecutive patients. J Pediatr Surg,2009,44(8):1502-1505.
[11]黄颖初,黎观漩,曾格林.腹腔镜下腹膜外注水分离辅助内环口高位结扎术的疗效分析.现代医院,2019,19(8):1191-1193.
[12]杨桦,黄红艺,吴鸿根,等.注水分离腹膜法在腹腔镜小儿疝手术中的应用.中华腔镜外科杂志(电子版),2013,6(2):25-27.
[13]孟繁杰,李燕书,黎辉,等.腹膜外水分离法在儿童腹股沟斜疝单孔腹腔镜疝囊高位结扎术中的应用.中华疝和腹壁外科杂志(电子版),2013,7(5):424-426.
[14]李琦,张建华,郑沛.腹腔镜下18G静脉留置针内置线经皮鞘状突高位环扎术治疗小儿鞘膜积液的经验总结.中华泌尿外科杂志,2016,37(12):945-946.
[15]李索林,费川,张永婷,等.水分离双钩套扎针辅助单孔腹腔镜腹股沟疝腹膜外结扎术.中国微创外科杂志,2017,17(1):42-45.
[16]刘琳,李索林.腹腔镜技术诊治小儿腹股沟疝的演化.中华小儿外科杂志,2016,37(10):796.

备注/Memo

备注/Memo:
*通讯作者,Email:pidankangkang@163.com ①肝胆疝外科
更新日期/Last Update: 2021-04-02