单孔腹腔镜下硬膜外穿刺针技术治疗小儿隐匿性斜疝的疗效
摘要
目的探讨单孔腹腔镜下应用硬膜外穿刺针技术治疗小儿隐匿性腹股沟斜疝的疗效。方法选择2017年11月至2018年10月安徽医科大学第一附属医院小儿外科收治的隐匿性腹股沟斜疝患儿120例,在单孔腹腔镜下用硬膜外穿刺针实施探查及腹膜外内环口疝囊结扎术。观察手术效果及并发症发生情况。结果 120例患儿均顺利完成手术,无中转开腹,无阴囊血肿及皮下气肿等发生,1例(0. 83%)患儿出现脐部穿刺孔大网膜脱出。术后1～2 d出院,术后门诊随访1个月,5例(4. 2%)患儿出现皮下线结反应,无一例患儿出现疝复发、医源性隐睾及睾丸萎缩。结论单孔腹腔镜下应用硬膜外穿刺针技术治疗小儿隐匿性腹股沟斜疝,具有创伤小、安全性高、住院时间短、并发症少、器械要求不高等优点,适合在有腔镜手术经验的基层医院推广应用。
引文
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[6]程康文,孙学工,王贵和,等.经皮腹膜外疝囊高位结扎术治疗小儿单侧腹股沟疝的疗效及对侧鞘状突未闭探查的意义[J].中国普通外科杂志,2016,25(10):1480-1487.
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[8]费川,张永婷,李索林,等.单孔腹腔镜双钩疝针内环结扎并脐内侧襞遮盖术[J/CD].中华腔镜外科杂志(电子版),2016,9(5):277-280.
[9]许冬阳,杨清渭,王书苗.腹腔镜二孔法与开放手术治疗小儿腹股沟斜疝嵌顿的对比分析[J].福建医学杂志,2018,40(4):29-33.
[10]中华小儿外科学分会内镜外科学组.小儿腹股沟疝腹腔镜手术操作指南(2017版)(上篇)[J/CD].中华疝和腹壁外科杂志(电子版),2018,12(1):1-5.
[11]中华医学会小儿外科学分会内镜外科学组.小儿腹股沟疝腹腔镜手术操作指南(2017版)(下篇)[J/CD].中华疝和腹壁外科杂志(电子版),2018,12(2):81-85.
[12]崔钊,鲁莹,李秋琳.单孔腹腔镜治疗儿童巨大腹股沟斜疝[J].中国微创外科杂志,2018,18(9):799-801
[13]XIANG B,JIN S,ZHONG L,et al.Reasons for recurrence after the laparoscopic repair of indirect inguinal hernia in children[J].J Laparoendosc Adv Surg Tech A,2015,25(8):681-683.
[2]DEMOURON M,DELFORGE X,BUISSON P,et al.Is contralateral inguinal exploration necessary in preterm girls undergoing inguinal hernia repair during the first months of life?[J].Pediatr Surg Int,2018,34(11):1151-1155.
[3]LARREINA DE LA FUENTE L,VILLALON FERRERO F,URBISTONDO GALARRAGA A,et al.Laparoscopic repair of inguinal hernia and communicating hydrocele in children.Our experience in the last years[J].Cir Pediatr,2018,31(3):125-129.
[4]LE ROUX F,LIPSKER A,MESUREUR S,et al.Inguinal hernia repair in children:surgical technique[J].J Visc Surg,2016,153(2):121-125.
[5]李索林,刘琳,杨晓锋.腹腔镜技术诊治小儿腹股沟斜疝的现状与评价[J].中华小儿外科杂志,2014,35(6):406-409.
[6]程康文,孙学工,王贵和,等.经皮腹膜外疝囊高位结扎术治疗小儿单侧腹股沟疝的疗效及对侧鞘状突未闭探查的意义[J].中国普通外科杂志,2016,25(10):1480-1487.
[7]刘伟,徐纪荣.腹腔镜结合术前彩超对小儿隐匿性斜疝的诊断与治疗探讨[J].当代医学,2014,20(11):111-112.
[8]费川,张永婷,李索林,等.单孔腹腔镜双钩疝针内环结扎并脐内侧襞遮盖术[J/CD].中华腔镜外科杂志(电子版),2016,9(5):277-280.
[9]许冬阳,杨清渭,王书苗.腹腔镜二孔法与开放手术治疗小儿腹股沟斜疝嵌顿的对比分析[J].福建医学杂志,2018,40(4):29-33.
[10]中华小儿外科学分会内镜外科学组.小儿腹股沟疝腹腔镜手术操作指南(2017版)(上篇)[J/CD].中华疝和腹壁外科杂志(电子版),2018,12(1):1-5.
[11]中华医学会小儿外科学分会内镜外科学组.小儿腹股沟疝腹腔镜手术操作指南(2017版)(下篇)[J/CD].中华疝和腹壁外科杂志(电子版),2018,12(2):81-85.
[12]崔钊,鲁莹,李秋琳.单孔腹腔镜治疗儿童巨大腹股沟斜疝[J].中国微创外科杂志,2018,18(9):799-801
[13]XIANG B,JIN S,ZHONG L,et al.Reasons for recurrence after the laparoscopic repair of indirect inguinal hernia in children[J].J Laparoendosc Adv Surg Tech A,2015,25(8):681-683.