经脐两孔法腹腔镜腹股沟疝内环高位结扎加脐外侧襞加强术治疗小儿腹股沟斜疝(附108例报告)

目的:探讨经脐两孔法腹腔镜腹股沟疝内环高位结扎加脐外侧襞加强术治疗小儿腹股沟疝的临床应用价值。方法:回顾分析108例腹股沟斜疝患儿的临床资料,55例行腹腔镜经脐两孔法腹股沟疝内环高位结扎加脐外侧襞加强术(A组),53例行腹腔镜腹股沟疝内环高位结扎加脐外侧襞加强术(B组)。结果:108例手术均顺利完成,A组单侧手术时间平均(10.5±2.8)min,双侧手术时间平均(16.5±2.1)min,术中出血量(2.5±0.4)ml,平均住院(2.0±0.4)d,住院费用(4 782.0±58.3)元,与B组相比,上述指标差异均无统计学意义(P0.05);术中两组均无并发症发生。术后随访3年以上,均无复发,A组中4例患儿发生腹股沟区疼痛,B组11例,两组相比差异有统计学意义(P0.05)。结论:经脐两孔法腹腔镜腹股沟疝内环高位结扎加脐外侧襞加强术具有切口更隐蔽、疼痛更轻微的特点,手术时间、住院时间、安全性与传统入路相比无明显差异,可在临床进一步推广。

Two-port laparoscopic transumbilical high ligation of inguinal hernia inner ring plus lateral umbilical fold coverage in the treatment of pediatric indirect inguinal hernia:with a report of 108 cases

Objective:To investigate the clinical value of two-port laparoscopic transumbilical high ligation of inguinal hernia inner ring plus lateral umbilical fold coverage in the treatment of pediatric indirect inguinal hernia .Methods:Clinical data of 108 chil-dren with indirect inguinal hernia admitted in the Second People's Hospital of Guangdong Province were analyzed retrospectively .55 pa-tients ( group A) were treated with two-port laparoscopic transumbilical high ligation of inguinal hernia inner ring plus lateral umbilical fold coverage,and 53 patients (group B) underwent laparoscopic high ligation of inguinal hernia inner ring plus lateral umbilical fold coverage.Results:All 108 operations were successfully completed .In group A,the unilateral operation time was (10.5 ±2.8) min,the bilateral operation time was (16.5 ±2.1) min,the average intraoperative blood loss was (2.5 ±0.4) ml,the average hospital stay was (2.0 ±0.4) d,the average hospitalization cost was (4 782.0 ±58.3) yuan,the above indicators were not different from those in group B (P>0.05).There were no complications during the operation and no recurrence after 3 years’ follow-up.In group A,there were 4 cases of pain in groin area and 11 cases in group B,the difference was statistically significant (P<0.05).Conclusions:Two-port lapa-roscopic transumbilical high ligation of inguinal hernia inner ring plus lateral umbilical fold coverage shows a more covert incision and less pain.There are no significant differences in operation time ,hospital stay and safety compared with the traditional approach ,and it could be further generalized in clinic .