腹腔镜下经皮腹膜外疝囊高位结扎术治疗学龄前儿童腹股沟斜疝的临床效果分析_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 朱信强 , 丁闯 , 张明 , 苏小虎 ,  陈焰

南京大学医学院附属南京鼓楼医院集团宿迁市人民医院普外科（江苏宿迁 223800）;

Corresponding author：

陈焰, Email: 1251533720@qq.com

Keywords：

腹股沟斜疝; 学龄前儿童; 腹腔镜; 经皮腹膜外疝囊高位结扎术

DOI：

10.7507/1007-9424.20150093

Video：

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目的探讨腹腔镜下经皮腹膜外疝囊高位结扎术治疗学龄前儿童腹股沟斜疝的临床效果。方法回顾性分析笔者所在医院2014年1～12月期间收治的53例学龄前儿童腹股沟斜疝患者的临床资料。结果本组53例患儿均顺利度过手术，无中转手术病例。手术时间11～14 min、（11.35±2.11）min；术中出血5～10 mL、（7.00±3.15）mL；住院时间2～3 d，中位数为2.6 d。术中发现对侧隐匿疝8例，以同法处理，均获成功。术后2例患儿发生阴囊肿胀，其余无积血、积液、腹痛等并发症发生。术后53例患儿均获访，随访时间3～6个月，中位数为4.5个月。随访期间无复发病例，1例单侧腹股沟斜疝患儿对侧发生新发疝。结论腹腔镜下经皮腹膜外疝囊高位结扎术治疗学龄前儿童腹股沟斜疝是可行的，其手术操作简便、住院时间短、术后并发症少，值得临床推广。

Citation： 朱信强, 丁闯, 张明, 苏小虎, 陈焰. 腹腔镜下经皮腹膜外疝囊高位结扎术治疗学龄前儿童腹股沟斜疝的临床效果分析. 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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2.	张启瑜. 钱礼腹部外科学. 北京:人民卫生出版社, 2006:31-32.
3.	梁红花. 小儿腹股沟斜疝疝囊高位结扎术的手术配合. 中华疝和腹壁外科杂志:电子版, 2010, 4(3): 327-328.
4.	郑民华, 马君俊. 腹腔镜腹股沟疝修补术的现状与前景展望. 中华疝和腹壁外科杂志:电子版, 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.	陈孝平, 汪建平. 外科学. 第8版. 北京:人民卫生出版社, 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.
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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.	刘斌, 陈金辉. Lichtenstein无张力疝修补术中腹股沟区神经处理的体会. 中国普外基础与临床杂志, 2012, 19(3):314-318.
15.	张冬, 黄永. 腹腔镜下内外环联合修补术治疗小儿复发疝163例报道. 中国普外基础与临床杂志, 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.	杨勇, 王敏, 胡雄辉, 等. 腹腔镜治疗小儿腹股沟疝的临床价值. 四川医学, 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.	谢丽帕·艾比不拉, 吴育, 克里木. 腹腔镜下小儿腹股沟斜疝手术的麻醉分析. 中华疝与腹壁外科杂志:电子版, 2010, 4(4):373-377.

1. 唐健雄. 腹股沟疝修补的现状与进展. 中华普外科手术学杂志:电子版, 2007, 1(2):1-4.
2. 张启瑜. 钱礼腹部外科学. 北京:人民卫生出版社, 2006:31-32.
3. 梁红花. 小儿腹股沟斜疝疝囊高位结扎术的手术配合. 中华疝和腹壁外科杂志:电子版, 2010, 4(3): 327-328.
4. 郑民华, 马君俊. 腹腔镜腹股沟疝修补术的现状与前景展望. 中华疝和腹壁外科杂志:电子版, 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. 陈孝平, 汪建平. 外科学. 第8版. 北京:人民卫生出版社, 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. 刘斌, 陈金辉. Lichtenstein无张力疝修补术中腹股沟区神经处理的体会. 中国普外基础与临床杂志, 2012, 19(3):314-318.
15. 张冬, 黄永. 腹腔镜下内外环联合修补术治疗小儿复发疝163例报道. 中国普外基础与临床杂志, 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. 杨勇, 王敏, 胡雄辉, 等. 腹腔镜治疗小儿腹股沟疝的临床价值. 四川医学, 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. 谢丽帕·艾比不拉, 吴育, 克里木. 腹腔镜下小儿腹股沟斜疝手术的麻醉分析. 中华疝与腹壁外科杂志:电子版, 2010, 4(4):373-377.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

腹腔镜下经皮腹膜外疝囊高位结扎术治疗学龄前儿童腹股沟斜疝的临床效果分析

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