腹腔鏡下經皮腹膜外疝囊高位結扎術治療學齡前兒童腹股溝斜疝的臨床效果分析_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 朱信強 , 丁闖 , 張明 , 蘇小虎 ,  陳焰

南京大學醫學院附屬南京鼓樓醫院集團宿遷市人民醫院普外科（江蘇宿遷 223800）;

Corresponding?author：

陳焰, Email: 1251533720@qq.com

Keywords：

腹股溝斜疝; 學齡前兒童; 腹腔鏡; 經皮腹膜外疝囊高位結扎術

DOI：

10.7507/1007-9424.20150093

Video：

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目的探討腹腔鏡下經皮腹膜外疝囊高位結扎術治療學齡前兒童腹股溝斜疝的臨床效果。方法回顧性分析筆者所在醫院2014年1～12月期間收治的53例學齡前兒童腹股溝斜疝患者的臨床資料。結果本組53例患兒均順利度過手術，無中轉手術病例。手術時間11～14 min、（11.35±2.11）min；術中出血5～10 mL、（7.00±3.15）mL；住院時間2～3 d，中位數為2.6 d。術中發現對側隱匿疝8例，以同法處理，均獲成功。術后2例患兒發生陰囊腫脹，其余無積血、積液、腹痛等并發癥發生。術后53例患兒均獲訪，隨訪時間3～6個月，中位數為4.5個月。隨訪期間無復發病例，1例單側腹股溝斜疝患兒對側發生新發疝。結論腹腔鏡下經皮腹膜外疝囊高位結扎術治療學齡前兒童腹股溝斜疝是可行的，其手術操作簡便、住院時間短、術后并發癥少，值得臨床推廣。

Citation： 朱信強, 丁闖, 張明, 蘇小虎, 陳焰. 腹腔鏡下經皮腹膜外疝囊高位結扎術治療學齡前兒童腹股溝斜疝的臨床效果分析. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(3): 348-350. doi: 10.7507/1007-9424.20150093 Copy

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3.	梁紅花. 小兒腹股溝斜疝疝囊高位結扎術的手術配合. 中華疝和腹壁外科雜志:電子版, 2010, 4(3): 327-328.
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5.	Al-Salem AH, Zamakhshary M, Al Mohaidly M, et al. Congenital Morgagni's hernia:a national multicenter study. J Pediatr Surg, 2014, 49(4):503-507.
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9.	Zhou X, Peng L, Sha Y, et al. Transumbilical endoscopic surgery for incarcerated inguinal hernias in infants and children. J Pediatr Surg, 2014, 49(1):214-217.
10.	Saka R, Okuyama H, Sasaki T, et al. Safety and efficacy of laparoscopic percutaneous extraperitoneal closure for inguinal hernias and hydroceles in children:a comparison with traditional open repair. J Laparoendosc Adv Surg Tech A, 2014, 24(1):55-58.
11.	Pant N, Aggarwal SK, Ratan SK. Laparoscopic repair of hernia in children:comparison between ligation and nonligation of sac. J Indian Assoc Pediatr Surg, 2014, 19(2):76-79.
12.	Wolak PK, Patkowski D. Laparoscopic inguinal hernia repair in children using the percutaneous internal ring suturing technique own experience. Wideochir Inne Tech Malo Inwazyjne, 2014, 9(1):53-58.
13.	Bjurstrom MF, Nicol AL, Amid PK, et al. Pain control following inguinal herniorrhaphy:current perspectives. J Pain Res, 2014, 7:277-290.
14.	劉斌, 陳金輝. Lichtenstein無張力疝修補術中腹股溝區神經處理的體會. 中國普外基礎與臨床雜志, 2012, 19(3):314-318.
15.	張冬, 黃永. 腹腔鏡下內外環聯合修補術治療小兒復發疝163例報道. 中國普外基礎與臨床雜志, 2012, 19(12):1344-1346.
16.	Boo YJ, Han HJ, Ji WB, et al. Laparoscopic hernia sac transection and intracorporeal ligation show very low recurrence rate in pediatric inguinal hernia. J Laparoendosc Adv Surg Tech A, 2012, 22(7):720-723.
17.	Chen K, Xiang G, Wang H, et al. Towards a near-zero recurrence rate in laparoscopic inguinal hernia repair for pediatric patients. J Laparoendosc Adv Surg Tech A, 2011, 21(5):445-448.
18.	Mishra PK, Burnand K, Minocha A, et al. Incarcerated inguinal hernia management in children:a comparison of the open and laparoscopic approach. Pediatr Surg Int, 2014, 30(6):621-624.
19.	楊勇, 王敏, 胡雄輝, 等. 腹腔鏡治療小兒腹股溝疝的臨床價值. 四川醫學, 2013, 34(5):632-633.
20.	Zhong H, Wang F. Contralateral metachronous hernia following negative laparoscopic evaluation for contralateral patent processus vaginalis:a meta-analysis. J Laparoendosc Adv Surg Tech A, 2014, 24(2):111-116.
21.	Xingwei X, Xin G, Peng Z, et al. Low-dose ketamine pretreatment reduces oxidative damage and inflammatory response following CO₂ pneumoperitoneum in rats. Clin Invest Med, 2014, 37(3):E124.
22.	謝麗帕·艾比不拉, 吳育, 克里木. 腹腔鏡下小兒腹股溝斜疝手術的麻醉分析. 中華疝與腹壁外科雜志:電子版, 2010, 4(4):373-377.

1. ?唐健雄. 腹股溝疝修補的現狀與進展. 中華普外科手術學雜志:電子版, 2007, 1(2):1-4.
2. 張啟瑜. 錢禮腹部外科學. 北京:人民衛生出版社, 2006:31-32.
3. 梁紅花. 小兒腹股溝斜疝疝囊高位結扎術的手術配合. 中華疝和腹壁外科雜志:電子版, 2010, 4(3): 327-328.
4. 鄭民華, 馬君俊. 腹腔鏡腹股溝疝修補術的現狀與前景展望. 中華疝和腹壁外科雜志:電子版, 2007, 1(2): 65-67.
5. Al-Salem AH, Zamakhshary M, Al Mohaidly M, et al. Congenital Morgagni's hernia:a national multicenter study. J Pediatr Surg, 2014, 49(4):503-507.
6. Li SL, Liu L, Li M. Single-port laparoscopic percutaneous extraperi-toneal closure using an innovative apparatus for pediatric inguinal hernia. J Laparoendosc Adv Surg Tech A, 2014, 24(3):188-193.
7. 陳孝平, 汪建平. 外科學. 第8版. 北京:人民衛生出版社, 2014:327-328.
8. Shalaby R, Ismail M, Samaha A, et al. Laparoscopic inguinal hernia repair; experience with 874 children. J Pediatr Surg, 2014, 49(3):460-464.
9. Zhou X, Peng L, Sha Y, et al. Transumbilical endoscopic surgery for incarcerated inguinal hernias in infants and children. J Pediatr Surg, 2014, 49(1):214-217.
10. Saka R, Okuyama H, Sasaki T, et al. Safety and efficacy of laparoscopic percutaneous extraperitoneal closure for inguinal hernias and hydroceles in children:a comparison with traditional open repair. J Laparoendosc Adv Surg Tech A, 2014, 24(1):55-58.
11. Pant N, Aggarwal SK, Ratan SK. Laparoscopic repair of hernia in children:comparison between ligation and nonligation of sac. J Indian Assoc Pediatr Surg, 2014, 19(2):76-79.
12. Wolak PK, Patkowski D. Laparoscopic inguinal hernia repair in children using the percutaneous internal ring suturing technique own experience. Wideochir Inne Tech Malo Inwazyjne, 2014, 9(1):53-58.
13. Bjurstrom MF, Nicol AL, Amid PK, et al. Pain control following inguinal herniorrhaphy:current perspectives. J Pain Res, 2014, 7:277-290.
14. 劉斌, 陳金輝. Lichtenstein無張力疝修補術中腹股溝區神經處理的體會. 中國普外基礎與臨床雜志, 2012, 19(3):314-318.
15. 張冬, 黃永. 腹腔鏡下內外環聯合修補術治療小兒復發疝163例報道. 中國普外基礎與臨床雜志, 2012, 19(12):1344-1346.
16. Boo YJ, Han HJ, Ji WB, et al. Laparoscopic hernia sac transection and intracorporeal ligation show very low recurrence rate in pediatric inguinal hernia. J Laparoendosc Adv Surg Tech A, 2012, 22(7):720-723.
17. Chen K, Xiang G, Wang H, et al. Towards a near-zero recurrence rate in laparoscopic inguinal hernia repair for pediatric patients. J Laparoendosc Adv Surg Tech A, 2011, 21(5):445-448.
18. Mishra PK, Burnand K, Minocha A, et al. Incarcerated inguinal hernia management in children:a comparison of the open and laparoscopic approach. Pediatr Surg Int, 2014, 30(6):621-624.
19. 楊勇, 王敏, 胡雄輝, 等. 腹腔鏡治療小兒腹股溝疝的臨床價值. 四川醫學, 2013, 34(5):632-633.
20. Zhong H, Wang F. Contralateral metachronous hernia following negative laparoscopic evaluation for contralateral patent processus vaginalis:a meta-analysis. J Laparoendosc Adv Surg Tech A, 2014, 24(2):111-116.
21. Xingwei X, Xin G, Peng Z, et al. Low-dose ketamine pretreatment reduces oxidative damage and inflammatory response following CO₂ pneumoperitoneum in rats. Clin Invest Med, 2014, 37(3):E124.
22. 謝麗帕·艾比不拉, 吳育, 克里木. 腹腔鏡下小兒腹股溝斜疝手術的麻醉分析. 中華疝與腹壁外科雜志:電子版, 2010, 4(4):373-377.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

腹腔鏡下經皮腹膜外疝囊高位結扎術治療學齡前兒童腹股溝斜疝的臨床效果分析

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