腹腔镜手术治疗成人腹股沟疝合并隐睾8例报告
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摘要
目的:探讨腹腔镜一期手术治疗成人腹股沟疝合并隐睾的可行性及安全性。方法:回顾分析2014年12月至2018年12月收治的8例成人腹股沟疝合并隐睾患者的病史、临床表现、辅助检查、手术治疗方式、术后并发症及复发情况等临床资料。结果:8例患者均顺利完成腹腔镜下经腹腹膜前腹股沟疝修补术+隐睾切除术,手术时间75～150 min,平均(87.6±9.4)min;术中出血量5～10 mL,平均(7.3±2.5)mL;术后住院2～7 d,平均(4.2±2.3)d。术后1例患者出现阴囊血清肿,无大出血、切口感染、顽固性神经性疼痛、补片排斥等其他并发症。随访6～30个月,平均(20.5±6.4)个月,无复发病例。结论:腹腔镜手术治疗成人腹股沟疝合并隐睾疗效确切,手术创伤小,术后康复快,具有很高的安全性及可行性。
Objective:To discuss the feasibility and safety of laparoscopic minimally invasive surgery in the treatment of inguinal hernia and cryptorchidism in adults.Methods:The clinical data of 8 cases of adult inguinal hernia with cryptorchidism from Dec.2014 to Dec.2018 were retrospectively analyzed,including the medical history,clinical manifestation,auxiliary examination,surgical treatment,postoperative complications and recurrence.Results:All 8 patients were successfully performed laparoscopic transabdominal preperitoneal hernia repair plus cryptorchidectomy.The operation time was 75-150 min,with an average of(87.6±9.4)min.The intraoperative blood loss was 5 to 10 mL,with an average of(7.3±2.5)mL,and the postoperative hospitalization time was 2 to 7 d,with an average of(4.2±2.3)d.The seroma of the scrotum was found in 1 patient after operation.There were no hemorrhage,incision infection,intractable neuropathic pain or patch rejection after operation.The follow-up time was 6-30 months,with an average of(20.5±6.4) months.No recurrence of hernia occurred.Conclusions:For adults with inguinal hernia combined with cryptorchidism,laparoscopic surgery is effective,minimally invasive with quick recovery after operation,high safety and feasibility.
Objective:To discuss the feasibility and safety of laparoscopic minimally invasive surgery in the treatment of inguinal hernia and cryptorchidism in adults.Methods:The clinical data of 8 cases of adult inguinal hernia with cryptorchidism from Dec.2014 to Dec.2018 were retrospectively analyzed,including the medical history,clinical manifestation,auxiliary examination,surgical treatment,postoperative complications and recurrence.Results:All 8 patients were successfully performed laparoscopic transabdominal preperitoneal hernia repair plus cryptorchidectomy.The operation time was 75-150 min,with an average of(87.6±9.4)min.The intraoperative blood loss was 5 to 10 mL,with an average of(7.3±2.5)mL,and the postoperative hospitalization time was 2 to 7 d,with an average of(4.2±2.3)d.The seroma of the scrotum was found in 1 patient after operation.There were no hemorrhage,incision infection,intractable neuropathic pain or patch rejection after operation.The follow-up time was 6-30 months,with an average of(20.5±6.4) months.No recurrence of hernia occurred.Conclusions:For adults with inguinal hernia combined with cryptorchidism,laparoscopic surgery is effective,minimally invasive with quick recovery after operation,high safety and feasibility.
引文
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[11] Rhee KS,Cherullo EE,Rosen M,et al.Role of laparoscopic hernia repair in men with a previous negative inguinal exploration for a cryptorchid testicle[J].Surg Laparosc Endosc Percutan Tech,2008,18(1):109-111.
[12] de la Torre RA,Scott JS,Blumenthal MF.Management of intraabdominal testicle during laparoscopic hernia repair[J].Surg Endosc,1995,9(6):711-713.
[2] 刘嘉林,鲍世韵,毕建钢,等.腹腔镜一期治疗成人隐睾伴腹股沟斜疝7例报道[J].中国内镜杂志,2009,15(1):107-108.
[3] 李敏,杨金瑞.230例隐睾临床分析[J].中华泌尿外科杂志,2004,25(5):348-350.
[4] 吴阶平.泌尿外科学[M].济南:山东科学技术出版社,1993:746-747.
[5] 赵夭望,刘国庆,郑为,等.腹腔镜手术治疗高位隐睾37例报告[J].中华泌尿外科杂志,2002,23(11):646.
[6] Hrebinko RL,Bellinger MF.The limited role of imaging techniques in managing children with undescended testes[J].J Urol,1993,150(2 Pt 1):458-460.
[7] 王欣,关勇,孟庆娅,等.腹腔镜微创手术与传统开放手术治疗小儿隐睾的疗效对比研究[J].临床泌尿外科杂志,2017,32(1):39-41.
[8] He D,Lin T,Wei G,et al.Laparoscopic orchiopexy for treating inguinal canalicular palpable undescended testis[J].J Endourol,2008,22(8):1745-1749.
[9] Hensel KO,Caspers T,Jenke AC,et al.Operative management of cryptorchidism:guidelines and reality--a 10-year observational analysis of 3587 cases[J].BMC Pediatr,2015,15:116.
[10] 姜井颂,张锡山,钟先荣,等.腹腔镜下腹股沟疝修补术的术式选择与效果[J].中国普通外科杂志,2012,21(2):196-199.
[11] Rhee KS,Cherullo EE,Rosen M,et al.Role of laparoscopic hernia repair in men with a previous negative inguinal exploration for a cryptorchid testicle[J].Surg Laparosc Endosc Percutan Tech,2008,18(1):109-111.
[12] de la Torre RA,Scott JS,Blumenthal MF.Management of intraabdominal testicle during laparoscopic hernia repair[J].Surg Endosc,1995,9(6):711-713.