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腹腔镜手术在11例小儿特殊类型腹股沟嵌顿疝治疗中的应用
朱真闯,闫学强,杨俊,段栩飞,卞红强*,汪昕,匡后芳
0
(华中科技大学同济医学院附属武汉儿童医院普外科, 武汉 430016
*通信作者)
摘要:
目的 探索经脐双孔法腹腔镜手术治疗小儿特殊类型腹股沟嵌顿疝的临床价值。方法 回顾性分析2012年12月至2015年11月华中科技大学同济医学院附属武汉儿童医院收治的11例行腹腔镜手术的特殊类型腹股沟嵌顿疝患儿的临床资料,对患儿的一般资料、手术方法、住院时间、术后并发症等进行分析。结果 4例Amyand疝均行腹腔镜手术;3例合并美克尔憩室,其中2例同时行全腹腔镜下美克尔憩室切除,1例为Littre疝,经脐小切口行美克尔憩室切除肠吻合术;1例腹股沟直疝伴大网膜嵌顿行腹腔镜手术;3例合并嵌顿肠管浆肌层撕裂行腹腔镜下肠修补术。所有患儿术后均无切口感染、阴囊血肿发生,平均住院时间(5.9±2.4) d。术后随访10个月至3年,无睾丸萎缩、复发等。结论 经脐双孔法腹腔镜手术治疗小儿特殊类型腹股沟嵌顿疝安全、微创、恢复快,值得推广应用。
关键词:  腹股沟疝  嵌顿疝  腹腔镜检查  儿童
DOI:10.16781/j.0258-879x.2017.07.0938
投稿时间:2016-12-01修订日期:2017-02-11
基金项目:
Application of laparoscopy for special kinds of incarcerated inguinal hernias in children:a report of 11 cases
ZHU Zhen-chuang,YAN Xue-qiang,YANG Jun,DUAN Xu-fei,BIAN Hong-qiang*,WANG-Xin,KUANG Hou-fang
(Department of General Surgery, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430016, Hubei, China
*Corresponding author)
Abstract:
Objective To explore the clinical value of trans-umbilicus two-port laparoscopic operation on the treatment for special kinds of incarcerated inguinal hernias in children. Methods A retrospective analysis of the clinical data of 11 children underwent transumbilicus two-port laparoscopic operation for a special kind of incarcerated inguinal hernia from Dec. 2012 to Nov. 2015 in Wuhan Children's Hospital of Tongji Medical College of Huazhong University of Science & Technology. Then we analyzed the general data, operative methods, hospital stay and postoperative complications of the children. Results Four children with Amyand's hernia were cured by laparoscopic surgery. A Meckel's diverticulum was found in 3 children, 2 of them underwent the laparoscopic resection of Meckel's diverticulum, and one was Litter's hernia and was cured with transumbilical incision for Meckel's diverticulum resection and anastomosis. One case had direct inguinal hernia with greater omentum hernia and was cured by laparoscopy. Three cases had seromuscular tear of incarcerated intestine and were cured by aparoscopic intestinal repair surgery. The average hospital stay of all cases was (5.9±2.4) d, and no incision infection or postoperative scrotal hematoma were found. All the children were followed up for 10 months to 3 years, and recurrence or testicular atrophy were not seen. Conclusion Transumbilical two-port laparoscopic operation is safe, minimally invasive and quick has recovery for the special kinds of incarcerated inguinal hernias, making it of worthy popularizing widely.
Key words:  inguinal hernia  incarcerated hernia  laparoscopy  child