Li Chunhua,Shen Qin.Efficacy of modified Bevan surgery for high cryptorchidism with oblique inguinal hernia in children[J].Journal of Clinical Pediatric Surgery,2025,(04):381-385.[doi:10.3760/cma.j.cn101785-202307057-015]
改良Bevan术治疗小儿高位隐睾伴腹股沟斜疝的疗效观察
- Title:
- Efficacy of modified Bevan surgery for high cryptorchidism with oblique inguinal hernia in children
- Keywords:
- Cryptorchidism; Hernia; Inguinal; Orchiopexy; Treatment Outcome; Postoperative Complications; Child
- 摘要:
- 目的 观察改良Bevan术治疗小儿高位隐睾伴腹股沟斜疝的临床效果、并发症以及对血清应激指标的影响。方法 对2018年7月至2021年2月恩施土家族苗族自治州中心医院85例高位隐睾伴腹股沟斜疝患儿资料进行回顾性分析,根据手术方法进行分组,45例实施改良Bevan术,纳入A组;40例实施Saha-jeap术,纳入B组。比较两组患儿围手术期指标(手术时间、术中出血量、术后肛门排气时间、术后住院时间),术后24 h血清皮质醇(cortisol,Cor)、前列腺素E2(prostaglandin E2,PGE2)及术后并发症、复发情况和外观满意度。结果 两组均顺利完成手术,睾丸均牵引至阴囊底部,血供良好。A组手术时间、术后肛门排气时间、术后住院时间均短于B组;术中出血量少于B组,术后24 h血清Cor、PGE2水平低于B组,术后随访6~12个月,A组并发症发生率低于B组(χ2=4.575,P<0.05),外观满意度高于B组(Z=2.234,P<0.05)。结论 相比于Saha-jeap术,改良Bevan术治疗小儿高位隐睾伴腹股沟斜疝在手术创伤、并发症及术后外观满意度等方面具有明显优势。
- Abstract:
- Objective To observe the efficacy and complications of modified Bevan surgery for high cryptorchidism with oblique inguinal hernia in children and examine the impact on serum stress parameters.Methods From July 2018 to February 2021,retrospective analysis was performed for 85 children with high cryptorchidism complicated with oblique inguinal hernia.According to surgical approaches,45 cases undergoing modified Bevan surgery were classified as group A while another 40 cases undergoing Saha-jeap surgery as group B.Perioperative parameters of operative duration,intraoperative volume of blood loss,postoperative anal exhaust time,postoperative hospitalization stay,serum levels of cortisol (Cor) and prostaglandin E2 (PGE2) at 24h post-operation,complications,recurrence and appearance satisfaction during 6-12 months of post-operative follow-ups were compared between two groups.Results All surgical procedures were successfully completed with testicle traction to scrotal bottom and abundant blood supply.The surgical time,postoperative anal exhaust time and postoperative hospital stay in group A were shorter than those in group B,and the intraoperative blood loss was less than that in group B,and the levels of serum Cor and PGE2 at 24 hours after surgery were lower than those in group B.At 6-12 months of follow-up after surgery,the incidence rate of complications in group A was lower than that in group B (χ2=4.575,P<0.05) while the appearance satisfaction was higher than that in group B (Z=2.23,P<0.05).Conclusions As compared with Saha-jeap surgery,modified Bevan surgery for high cryptorchidism with oblique inguinal hernia in children offers obvious advantages in terms of surgical trauma,complications and postoperative appearance satisfaction.
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备注/Memo
收稿日期:2023-7-27。
通讯作者:申琴,Email:tangal_ing@126.com