目的 探讨经脐部腹腔镜单针双线法治疗婴幼儿腹股沟斜疝的临床应用价值。方法 收集2013年1月至2016年7月由本院普外科收治的1 182例婴幼儿腹股沟斜疝患儿作为研究对象,其中656例在腹腔镜下采用单针双线法治疗(改良组),526例采用常规腹腔镜手术治疗(常规组),比较两组手术时间、住院时间、术后并发症的发生率等相关临床资料,评价两种不同手术方式的优缺点。结果 改良组平均手术时间(21±11)min,平均住院时间(2.1±1.2)d,术后随访1～15个月,平均6.3个月,阴囊红肿3例,患侧复发1 例,对侧鞘状突未闭295例; 常规组平均手术时间(22±10)min,平均住院时间(2.2±1.1)d,术后随访1～12个月,平均6.1个月,阴囊红肿1例,患侧复发1 例,对侧鞘状突未闭213例。改良手术较常规腹腔镜手术在术后切口出现皮下硬结、线结反应等方面具有优势,差异具有统计学意义(P<0.05)。结论 腹腔镜单针双线法治疗幼儿腹股沟斜疝无需特殊器械,创伤小,减少了术后并发症及患者不适,手术效果良好,具有较好的临床应用价值。
Objective To evaluate the clinical value of laparoscopy using a single-needle with double-line method in the treatment of inguinal hernia of infants. Methods From January 2013 to July 2016,a total of 1182 cases of inguinal hernia were divided into modified(laparoscopic single-needle & double-line,n=656)and conventional(n=526)groups. Retrospective review was conducted for clinical data of both groups. Two groups were compared with regards to operative duration,length of stay,postoperative complications,family satisfaction and other relevant clinical data to determine which surgical approach was better. Results The modified group were followed up for an average of 6.3(1-15)months. The average operative duration was 21±11 min. There were scrotal swelling(n=3),ipsilateral recurrence(n=1)and contralateral sheath-like protrusion(n=295); The conventional group were followed up for an average of 6.1(1-12)months. The average operative duration was 22±10 min. There were scrotal swelling(n=1),ipsilateral recurrence(n=1)and contralateral sheath-like protrusion(n=295).In modified group,there was subcutaneous induration of incision(n=1). In conventional group,there were subcutaneous induration of incision(n=430)and suture reaction(n=23). Compared with conventional laparoscopy,modified group was superior and the difference was statistically significant(P<0.05). Conclusion Compared with conventional laparoscopy,laparoscopic single-needle with double-line method requires no special equipment for hernia. With minimal trauma,it reduces postoperative complications and patient discomforts. So this surgical approach is effective and it can achieve excellent surgical outcomes and offer good clinical application value.
