单孔腹腔镜下大圆针体外二次缝合法治疗小儿腹股沟斜疝的疗效分析

目的探讨应用单孔腹腔镜下大圆针体外二次缝合法治疗小儿腹股沟斜疝的疗效。 方法2016年8月至2017年6月,南方医科大学附属何贤纪念医院收治且由同一手术团队治疗的小儿腹股沟斜疝患者共400例,均采用腹腔镜手术,分为观察组和对照组,其中观察组应用大圆针体外二次缝合法治疗小儿腹股沟斜疝208例,对照组应用大圆针及Endoclose腹壁缝合器治疗小儿腹股沟斜疝192例。回顾分析2组不同方法在手术时间、住院时间、住院费用、是否需要增加辅助钳、术中血管损伤、术后并发症及复发情况等。 结果2组患儿均顺利完成腹腔镜下疝囊高位结扎术,观察组和对照组在住院费用[单侧：（6.29±0.32）千元比（7.40±0.53）千元,双侧（8.85±0.65）千元比（9.60±0.38）千元]、是否需要增加辅助钳（106/208比48/192）方面比较,差异均有统计学意义（P均<0.05）;而手术时间、住院时间、术中血管损伤、术后并发症及复发情况差异无统计学意义（P均>0.05）。 结论单孔腹腔镜下大圆针体外二次缝合法行疝囊高位结扎术,操作简单、方便;无需"疝针"或腹壁缝合器即能完成手术,费用更低;而且该技术微创、安全,具有一定的临床推广价值。

Single-site laparoscopic percutaneous extraperitoneal closure of the internal ring using an ordinary taper needle for pediatric inguinal hernia: A retrospective comparative study

ObjectiveTo analyze a modified method of laparoscopic treatment for pediatric indirect inguinal hernia, single-site laparoscopic percutaneous extraperitoneal closure of the internal ring using an ordinary taper needle, to evaluate its safety and efficacy. MethodsDuring August 2016 and June 2017, 400 children with indirect inguinal hernia were operatedlaparoscopicallyin a same teamof surgeons. They were divided into two groups according to different operation procedureperformed. 208 cases were enrolled in the study group and all these patients had been underwent high ligation surgery with a modified single-site laparoscopic technique: mainly performed by extracorporeal suturing only with an ordinary taper needle (1/2 Arc 11x34). While the control group was consisted of 192 cases, and they were sutured by taper needle along withEndoclose needle. The clinical data were collected and analyzed retrospectively. ResultsAll surgeries were successful without serious complications. In terms of hospitalization expenses and Auxiliary forceps utilization, the differences were statistically significant (P<0.05). While on the issues of operative time, length of hospital stay, intraoperative vessels injury, postoperative complications and as well as recurrence rate, no significant differences were found between the two groups (P>0.05). ConclusionThe modified single-site laparoscopic percutaneous extraperitoneal closure of the internal ring using an ordinary taper needle for the repair of pediatric indirect inguinal hernia is a safe and reliable procedure, with minor invasion and satisfied outcome, and no specific device is needed hence more cost-saving. It is easy to learn and perform, and is worthy to be popularized in clinic.