新型夹线钳在小儿斜疝腹腔镜手术中的应用

Application of a new-type wire clamp in laparoscopic operation of indirect hernia in children

  • 摘要:
    目的  探讨新型夹线钳在腹腔镜小儿斜疝疝囊高位结扎术中的应用价值。
    方法  回顾性分析行腹股沟斜疝疝囊高位结扎术的112例患儿的临床资料和随访资料。根据患儿监护人意愿,使用新型夹线钳行腹腔镜下疝囊高位结扎术54例为腹腔镜组,行小切口腹股沟斜疝疝囊高位结扎术58例为对照组。比较2组手术时间、术中出血量、切口总长度、术后下床活动时间、术后住院时间。术后随访4~16个月,比较2组术后并发症和对侧异时性疝(MCH)的发生率。
    结果  所有患儿手术均顺利完成。腹腔镜组16例患儿在术中探查出合并对侧隐匿性斜疝,一并手术处理。腹腔镜组术中出血量、切口总长度、术后下床活动时间、术后住院时间小于或短于对照组,随访期间并发症发生率低于对照组,差异有统计学意义(P < 0.05)。行单侧手术患儿中,腹腔镜组发生MCH为0例,对照组为11例,差异有统计学意义(P < 0.05)。
    结论  新型夹线钳应用于腹腔镜小儿斜疝疝囊高位结扎术具有安全性高、副损伤小、耗材费用低、操作方便等优势。

     

    Abstract:
    Objective  To explore the application value of a new-type wire clamp in laparoscopic high ligation of indirect inguinal hernia sac in children.
    Methods  The clinical data and follow-up data of 112 children with laparoscopic high ligation of indirect inguinal hernia sac were analyzed retrospectively. According to the wishes of the children's guardians, 54 cases with laparoscopic high ligation of hernia sac by a new-type wire clamp were selected as laparoscopic group, and 58 cases with small incision high ligation of indirect inguinal hernia sac were selected as control group. The operation time, intraoperative blood loss, total incision length, time to postoperative bed-off activity and postoperative hospital stay were compared between the two groups. After 4 to 16 months of postoperative follow-up, the incidence of postoperative complications and the incidence of contralateral metachronous hernia (MCH) were compared between the two groups.
    Results  All the operations were successfully completed in children. In the laparoscopic group, 16 children with contralateral concealed indirect hernia were detected during operation and were treated at the same time. The intraoperative blood loss, the total length of incision, the time to postoperative bed-off activity and the length of hospital stay in the laparoscopic group were significantly lower than those in the control group, and the incidence of complications during follow-up was significantly lower than that in the control group (P < 0.05). Among the children with unilateral surgery, there was no case with MCH in the laparoscopic group, which was significantly less than 11 cases with MCH in the control group (P < 0.05).
    Conclusion  The new-type wire clamp in laparoscopic high ligation of indirect hernia sac in children has the advantages of high safety, small side injury, low cost and convenient operation.

     

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