单孔腹腔镜单次双线法治疗复杂性鞘膜积液的研究

目的探讨单孔腹腔镜单次双线法治疗复杂性鞘膜积液的临床疗效。 方法回顾性分析2013年2月至2016年9月我科行单孔腹腔镜单次双线法治疗的80例复杂性鞘膜积液患儿临床资料，脐上作一个5 mm切口，建立气腹并置入腹腔镜，鞘状突体表投影处做一个1 mm切口，将2-0肌腱线对折穿过自制钩针，腹腔镜直视下将针刺至鞘状突腹膜前，分别行内外半周荷包缝合，带出线结扎内环口。 结果所有患儿手术均顺利完成，无中转开放手术者，手术时间8~25 min，平均（19±4）min，均无切口及阴囊感染、水肿等并发症发生，术后住院时间（1.6±0.2）d，术后随访6~48个月，均未见复发及并发症，创口愈合完好，无明显瘢痕。 结论单孔腹腔镜单次双线法治疗复杂性小儿鞘膜积液安全可行，疗效确切，患儿创伤小，恢复快，值得临床推广应用。

Single-port laparoscopic double- line therapy for the treatment of complex hydrocele

ObjectiveTo study the clinical efficacy of single-port laparoscopic double-line therapy for treatment of complex hydrocele. MethodsFrom February 2013 to September 2016, 80 children with complex hydrocele treated by single-port laparoscopic double-line therapy in our hospital were retrospectively investigated. One 5 mm incision above the umbilicus was made to introduce a trocar. Then under direct visualization, 1 mm incision of skin at the processus vaginalis was made to introduce the sharp needle with a double fold 2-0 tendon threads. The sharp needle traveled at the extraperitoneal level to suture the lateral of internal ring. ResultsAll patients underwent the operation successfully without any conversion to open surgery. The operation time ranged from 8~25 minutes, average (19±4) min. There was no incision infection, scrotal edema or other complications. The postoperative hospital stay was (1.6±0.2) days. During 6 to 48 months follow-up, there was no recurrence or complication. The wound healed well without any scar. ConclusionThe single-port laparoscopic double-line therapy for treatment of complex hydrocele is safe, feasible, minimally invasive in children, which is worth to be spread.