单孔腹腔镜无痕技术治疗小儿对侧隐性疝的临床效果分析

目的 探讨单孔腹腔镜无痕技术治疗小儿对侧隐性疝的疗效.方法 回顾性分析四○四医院2013年6月至2016年6月收治的312例单侧腹股沟斜疝手术患儿,其中采用单孔腹腔镜无痕技术170例,普通开放手术142例.分析两种手术患儿性别,年龄,复发率,单侧疝发病部位,开放手术术后发生对侧异时疝的病例数,腹腔镜发现对侧鞘状突未闭的病例数,以及术后异时疝的发生时间.结果 普通开放手术共142例,男97.8％,女2.2％,平均年龄(2.45±2.18)岁;术后发生对侧异时疝5例,占3.5％,其中1例(0.7％)为右侧,4例(2.8％)为左侧,两者比较差异有统计学意义(x2=5.30,P=0.01),异时疝分别发生在术后8、14、18、20、24个月.有3例(2.1％)疝复发.腹腔镜手术共170例,男145例(85.3％),女25例(14.7％),平均年龄(2.44±2.15)岁,术中发现对侧鞘突未闭的隐性疝86例(50.6％),未发现异时性腹股沟斜疝,有1例(0.6％)在术后18个月复发,与开放手术患者比较差异有统计学意义(x2=10.12,P=0.01).结论 单孔腹腔镜治疗小儿单侧腹股沟斜疝较普通开放手术可准确判断有无对侧隐性疝并同时手术,其术后复发率和异时疝发生率均明显降低.

Analysis on effect of single port laparoscopic traceless technology for child contralateral latent hernia

Objective To explore the effect of single port laparoscopic traceless technology for child contralateral latent hernia.Methods Three hundred and twelve children cases of unilateral indirect inguinal hernia in Mianyang 404 Hospital from June 2013 to June 2016 were retrospectively analyzed.Among them,170 cases receivedsingle port laparoscopic traceless technology and 142 cases underwent common open surgery.The gender,age,recurrent rate,onset site of unilateral side,cases number of postoperative contralateral asynchrony hernia occurrence,cases number of contralateral vaginal process deformity found by laparoscopy and onset time of postoperative asynchrony hernia were compared between the two kinds of surgery.Results Among the 142 cases of common open surgery,male accounted for 97.8％ and female accounted for 2.2％,and the average age was (2.45±2.18) years old;the postoperative contralateral asynchrony hernia occurred in 5 cases (3.5％),in which 1 case (0.7％) was in the right side and 4 cases in the left side,the difference between them was statistically significant (x2 =5.30,P=0.01),the asynchrony hernia occurred in postoperative 8,14,18,20,24 months.Three cases (2.1 ％) had hernia relapse.The laparoscopic surgery had 170 cases,including 145 male cases (85.3％) and 25 female cases (14.7％),the average age was (2.44±2.15) years old.The intraoperation found 86 cases (50.6 ％) of latent hernia of contralateral vaginal process deformity,while the asynchrony inguinal indirect hernia was not found,1 case had the relapse in postoperative 18 months,the difference was statistically significant compared with the patients with open surgery (x2=10.12,P=0.01).Conclusion Single port laparoscopic surgery for treating child unilateral inguinal indirect hernia can accurately judge whether having contralateral latent hernia and simultaneously conducts the operation compared with the common open operation,its postoperative relapse rate and asynchrony hernia occurrence rate are significantly decreased.