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腹腔镜手术治疗小儿嵌顿性腹股沟斜疝

Laparoscopic surgery in the treatment of incarcerated indirect inguinal hernia in children.

作者信息

Yin Yiyu, Zhang Hongwei, Zhang Xiang, Sun Fang, Zou Huaxin, Cao Hui, Wen Cheng

机构信息

Department of Pediatric Surgery, Xuzhou Children's Hospital, Xuzhou, Jiangsu 221002, P.R. China.

出版信息

Exp Ther Med. 2016 Dec;12(6):3553-3556. doi: 10.3892/etm.2016.3830. Epub 2016 Oct 21.

Abstract

We aimed to explore the feasibility and the safety of the laparoscopic surgery for incarcerated indirect inguinal hernia (IIH) in children. From January 2012 to December 2014, 64 children were enrolled into this study. All 64 patients received laparoscopic surgery and we reviewed their perioperative and postoperative follow-up studies. In addition, we enrolled 60 cases of children who received traditional surgery of IIH administered through minimally invasive surgery as the control group. Results from the present study showed that the mean operation time for the laparoscopic group was 41.5 min (range, 15-80 min) which was significantly shorter than the control group. Nine cases developed incarcerated intestine necrosis, expanded umbilical incision and parallel resection anastomosis. They received laparoscopic hernia sac high ligation. Only 5 cases developed scrotum edema after the surgery. The postoperative length of the stay ranged from 2 to 7 days (average, 3.2). The postoperative follow-up was from 6 months to 1 year and no relapse or secondary testicular atrophy was observed in the laparoscopic group. The operation time, incidence of postoperative complications and length of stay in the laparoscopic group were decreased compared to the control group, and differences were statistically significant (P<0.05). In conclusion, laparoscopic surgery treatment for incarcerated inguinal hernia is safe and feasible and produced better results compared with the alternative.

摘要

我们旨在探讨腹腔镜手术治疗小儿嵌顿性腹股沟斜疝(IIH)的可行性和安全性。2012年1月至2014年12月,64例儿童纳入本研究。所有64例患者均接受腹腔镜手术,并对其围手术期和术后随访研究进行回顾。此外,我们纳入60例接受传统微创IIH手术的儿童作为对照组。本研究结果显示,腹腔镜组平均手术时间为41.5分钟(范围15 - 80分钟),明显短于对照组。9例出现嵌顿肠坏死,扩大脐部切口并行切除吻合术。他们接受了腹腔镜疝囊高位结扎术。术后仅5例出现阴囊水肿。术后住院时间为2至7天(平均3.2天)。术后随访6个月至1年,腹腔镜组未观察到复发或继发性睾丸萎缩。与对照组相比,腹腔镜组的手术时间、术后并发症发生率和住院时间均有所降低,差异有统计学意义(P<0.05)。总之,腹腔镜手术治疗嵌顿性腹股沟疝安全可行,与其他治疗方法相比效果更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdab/5228354/090e2b19f2eb/etm-12-06-3553-g00.jpg

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