【摘要】 目的:探讨微型腹腔镜套线法治疗小儿腹股沟斜疝及鞘膜积液的临床效果。方法:2001年8月至2007年3月用微型腹腔镜下操作钳配合自制带线雪橇针作腹膜外潜行缝合高位结扎疝囊治疗小儿腹股沟斜疝及鞘膜积液747例,共898侧。结果:手术切口创伤小,疝囊高位结扎确切,操作简单,手术时间短,并发症少,复发率低(0.9%),康复快,术后不留疤痕。结论:此手术安全,疗效确切,复发率低,值得临床推广应用。
【关键词】 微型腹腔镜;疝,腹股沟;鞘膜积液;儿童
Treatment for children s oblique inguinal hernia and hydrocele by lining through minilaparoscope:with a report of 747 cases
【Abstract】Objective:To explore the clinical use of minilaparoscopy in treating the children s oblique inguinal hernia and hydrocele by lining.Methods:From Aug.2001 to Mar.2007,747 cases with 898 sides of children s oblique inguinal hernia and hydrocele were treated using minilaparoscopy and selfmade sled needle to ligate hernial sac highly outside the peritoneal.Results:This treatment was associated with little trauma,short operative time,quick recovery,low recurrence(0.9%)and few complication.Conclusions:This treatment has exact curative effect and low recurrence.It is safe and worth being generalized in clinic.
【Key words】Minilaparoscope;Hernia,inguinal;Hydrocele;Child
2001年8月至2007年3月我们学习和借鉴国内腹腔镜治疗小儿腹股沟斜疝的方法,用套线法腹膜外潜行缝合高位结扎疝囊治疗小儿腹股沟斜疝及鞘膜积液747例,共898侧,疗效满意,现报道如下。
1 资料与方法
1.1 临床资料
本组747例中男684例,女63例。腹股沟斜疝561例、688侧;鞘膜积液186例、210侧。术前诊断为双侧斜疝4例,术中发现对侧隐性疝147例。2个月~15岁,平均4岁5个月。小于1岁者29例。
1.2 手术方法
术前禁饮食,自行排空膀胱。氯氨酮静脉麻醉。术中取平卧位,脐皱摺上缘皮肤切开3mm,提起腹壁皮肤刺入气腹针有明显突破感时充气形成人工气腹,根据年龄,气腹压力设于8~12mm Hg。气腹建立后提起腹壁皮肤置入3mm Trocar,当有气体溢出时,以3mm 0°腹腔镜探查是否进入腹腔并调整,检查腹腔内脏及血管有无损
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