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目的总结经脐单手单孔腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝的治疗经验。方法回顾性分析2013年10月至2015年9月期间我院采用经脐单手单孔腹腔镜下疝囊高位结扎术治疗小儿腹股沟斜疝的145例患者的临床资料。结果 145例腹股沟斜疝患者均在腹腔镜下完成疝囊高位结扎术,每侧手术时间5~8 min(平均6 min),双侧10~15 min(平均12 min)。有20例患儿术中发现对侧存在隐匿性疝,一并行疝囊高位结扎术。术后随访1~12个月,平均5个月,无精索血肿、医源性隐睾、睾丸萎缩、线结排斥反应、感染等并发症;有2例复发,其中1例为单侧疝,其腹膜皱褶严重;另1例为巨大单侧疝,其疝内容物反复突出形成瘢痕疝囊。结论经脐单手单孔腹腔镜下疝囊高位结扎术治疗小儿腹股沟斜疝,不仅具备传统腹腔镜手术的优点,而且安全、疗效确切、更加美观、手术时间亦无增加,更加节省人力,优于传统腹腔镜疝囊高位结扎术,远期疗效有待更长时间的随访和大宗病例的治疗效果。
Objective To summarize the experience of treatment of inguinal indirect inguinal hernia by lumbar single-hole laparoscopic high ligation of the umbilicus. Methods The clinical data of 145 patients with inguinal indirect hernia admitted to our hospital from October 2013 to September 2015 were retrospectively analyzed. Results 145 cases of inguinal hernia were performed laparoscopic high ligation of hernia sac, each operation time 5 ~ 8 min (average 6 min), both sides 10 ~ 15 min (average 12 min). There are 20 cases of children found in the contralateral occult hernia, a high ligation of hernia sac. The patients were followed up for 1 to 12 months with an average of 5 months without complications such as hematoma of spermatic cord, iatrogenic cryptorchidism, atrophy of testis, rejection of line knot, infection and so on. There were 2 recurrent cases, of which 1 was unilateral hernia , The peritoneal folds serious; the other case was a huge unilateral hernia, the hernia contents repeatedly highlighted the formation of scar hernia sac. Conclusion High lumbar single hernia sac with ligation of the umbilicus for treatment of inguinal indirect inguinal hernia in children not only possesses the advantages of traditional laparoscopic surgery, but also has the advantages of safety, curative effect, more esthetic, no increase of operation time and more labor saving In the traditional laparoscopic high ligation of hernia sac, long-term efficacy to be a longer period of follow-up and treatment of large cases.