Sowande O A, Olajide T A
Paediatric Surgery Unit, Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospital, Ile Ife, Osun State, Nigeria.
Ann Afr Med. 2011 Jan-Mar;10(1):38-40. doi: 10.4103/1596-3519.76581.
Ligation of a patent processus vaginalis via the inguinal approach is the standard operative technique for the treatment of hydroceles in infants and children. Although a simple technique, identification of the processus vaginalis can be difficult even for the experienced surgeon.
To investigate the use of methylene blue in the perioperative identification of the patent processus vaginalis in a group of children presenting with hydrocele.
Twenty consecutive patients with hydrocele between the ages of 1 and 9 years were recruited for the study. Methylene blue 0.3-0.5 ml was injected slowly into the hydrocele fluid through the scrotal wall after aspiration, followed by routine ligation of the hydrocele track.
The track of the processus vaginalis was clearly visualized in 17 (85%) of the patients, while in 3 (15%) patients no track could be seen, the hydrocele being localized to the tunica vaginalis. There were no cases of inadvertent testicular injury and there was no intraoperative complication. No patient reacted in any abnormal way to the methylene blue.
The technique helps in the identification of a patent processus vaginalis when it is present. It may be useful in cases where difficulty in identification of the hydrocele tract is anticipated in a child.
经腹股沟入路结扎未闭的鞘状突是治疗婴幼儿鞘膜积液的标准手术技术。尽管该技术简单,但即使是经验丰富的外科医生,识别鞘状突也可能存在困难。
研究亚甲蓝在一组鞘膜积液患儿围手术期识别未闭鞘状突中的应用。
连续招募20例年龄在1至9岁之间的鞘膜积液患儿进行研究。在抽吸鞘膜积液后,通过阴囊壁将0.3 - 0.5毫升亚甲蓝缓慢注入鞘膜积液中,随后常规结扎鞘膜积液通道。
17例(85%)患者的鞘状突通道清晰可见,而3例(15%)患者未见通道,鞘膜积液局限于鞘膜。无意外睾丸损伤病例,术中无并发症。无患者对亚甲蓝有任何异常反应。
该技术有助于识别存在的未闭鞘状突。对于预计在儿童中识别鞘膜积液通道困难的情况可能有用。