摘要
目的探讨经脐单孔直径1.1 mm腹腔镜手术治疗小儿鞘膜积液或腹股沟斜疝的疗效及优缺点。方法回顾性分析2022年1月至2023年8月深圳市宝安区妇幼保健院采用1.1 mm腹腔镜(STORZ 0°膀胱镜镜管,型号:27033AA)及自制穿刺器实施手术治疗的30例小儿鞘膜积液或腹股沟斜疝患儿临床资料及随访信息。根据切口大小及戳卡数量进行分组,采取脐部单个1.8 mm切口者为A组(n=30),脐部单个3.3 mm切口者为B组(n=30),脐部两个3.3 mm切口者为C组(n=80)。对比分析三组患儿性别、年龄、发病时间、病种、病变部位、手术时间(包括单侧手术时间及双侧手术时间)的差异。结果A组平均手术年龄2.57岁,平均随访时间5.22个月;B组平均手术年龄3.81岁,平均随访时间6.70个月;C组平均手术年龄2.81岁,平均随访时间6.38个月。三组术后均无一例复发、医源性隐睾、切口感染及阴囊水肿发生,C组有1例术后出现腹股沟区切口肉芽肿(1/80)。三组在性别、病种、单侧及双侧情况、手术时长、发病时长上比较,差异均无统计学意义(P>0.05)。三组患儿年龄及单侧手术时长的差异具有统计学意义(P值分别为0.030和0.039),组间两两比较显示,A、C组患儿平均年龄小于B组(A组比B组,P=0.012;C组比B组,P=0.024),A、C组患儿单侧手术时间多于B组(A组比B组,P=0.045;C组比B组,P=0.015)。结论经脐单孔1.1 mm腹腔镜对比经脐单孔3 mm腹腔镜及经脐双孔3 mm腹腔镜治疗小儿鞘膜积液或腹股沟斜疝,疗效相当,术后并发症无增加,手术安全可靠,具有切口更小、更微创,术后瘢痕更小、更美观等优点;但目前开展病例数较少,仍需经验积累和器械升级改造等。
Objective To explore the efficacy,advantages and disadvantages of treating pediatric hydrocele/inguinal hernia with a 1.1 mm diameter transumbilical single-port laparoscopy.Methods A retrospective analysis was conducted for the clinical data and follow-up findings of 30 children with hydrocele/inguinal hernia from January 2022 to August 2023.A STORZ 1.1 mm laparoscope was applied with a homemade Trocar.Based upon the size of incision and the number of puncture holes,they were assigned into three groups of A(a single 1.8 mm umbilical incision,n=30),B(a single 3.3 mm umbilical incision,n=30)and C(double 3.3 mm umbilical incisions,n=80).The differences in gender,onset time,age,disease type,lesion site and operative duration(unilateral/bilateral)were compared among three groups.Results In group A,the average operative age was 2.57 years with an average follow-up duration of 5.22 months.In group B,the average age was 3.81 years with an average follow-up duration of 6.70 months.In Group C,the average age was 2.81 years with an average follow-up duration of 6.38 months.None of them exhibited such postoperative complications as recurrence,iatrogenic cryptorchidism,incision infection or scrotal edema.However,one case(1/80)in group C developed postoperative granuloma at inguinal incision site.No statistically significant difference existed among three groups in terms of gender,type of disease,differences in unilateral/bilateral conditions before and during surgery,operative duration or duration of illness.However,the difference in average age and unilateral operative duration was statistically significant among three groups(P=0.030 and P=0.039).Average age of group A/C was lower than that in group B(P=0.012 and P=0.024).Unilateral operative duration was longer in group A/C than that in group B(P=0.045 and P=0.015).Conclusions As compared to 3 mm single-umbilical-port laparoscopy and 3 mm dual-umbilical-port laparoscopy,1.1 mm single-umbilical-port laparoscopy for pediatric hydrocele/inguinal hernia has demonstrated consistent surgical outcomes with no increase in postoperative complications.It is a safe and reliable surgery with mini-invasive scars.However,due to a limited number of cases,further experiences and equipment upgrades are required.
作者
余中景
林镇营
李焕源
杨梦成
袁马保
李冠钊
张宝欣
Yu Zhongjing;Lin Zhenying;Li Huanyuan;Yang Mengcheng;Yuan Mabao;Li Guanzhao;Zhang Baoxin(Department of Pediatric Surgery,Bao'an District Women&Children's Health Center,Shenzhen 518102,China)
出处
《临床小儿外科杂志》
CAS
CSCD
北大核心
2024年第6期584-588,共5页
Journal of Clinical Pediatric Surgery
关键词
睾丸鞘膜积液
疝
腹股沟
腹腔镜检查
治疗结果
对比研究
儿童
Testicular Hydrocele
Hernia,Inguinal
Laparoscopy
Treatment Outcome
Comparative Study
Child
作者简介
通信作者:张宝欣,Email:1305832155@qq.com.
