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目的探讨腹腔镜诊疗儿童隐匿性腹股沟疝的临床意义。方法回顾性分析2010年1月至2014年5月,新疆维吾尔自治区人民医院收治内环口直径>2 cm及手法无法复位的嵌顿性腹股沟疝患儿32例,均行开放手术疝囊高位结扎,前壁加强的同时从疝囊置入30°腹腔镜探查对侧腹股沟管内环口,如发现对侧腹股管内环口未闭或者开放的窦道为隐匿性疝则同时行内环口关闭术。结果本组共32例均行切开手术,术中发现隐匿性疝15例。术中同时处理对侧隐匿性疝时,手术时间延长5~10 min。术后均无切口感染或睾丸炎等并发症,术后出现阴囊水肿5例,阴囊抬高后自行好转。术后2~5 d出院。术后随访1个月至1年,无复发及睾丸回缩等。结论儿童隐匿性斜疝发病率较高,可从疝囊置入腹腔镜探查对侧并同时处理,可减少脐部切开探查,减少再次麻醉及手术的痛苦,降低医疗费用。
Objective To investigate the clinical significance of laparoscopic diagnosis and treatment of occult inguinal hernia in children. Methods Retrospective analysis from January 2010 to May 2014, Xinjiang Uygur Autonomous Region People’s Hospital for treatment of 32 cases of incarcerated inguinal hernia, the diameter of the internal ring mouth> 2 cm and the hand can not be reset, were performed open surgery high ligation of hernia sac , While strengthening the anterior wall from the hernia sac 30 laparoscopic exploration of contralateral inguinal canal in the mouth, if found in the contralateral abdominal canal orbital closure of the open sinus or occult herniation at the same time the inner ring mouth closed Surgery. Results A total of 32 patients underwent open surgery in this group, occult herniation was found in 15 cases. Intraoperative treatment of contralateral occult hernia, the operation time extended 5 ~ 10 min. No postoperative incision infection or orchitis and other complications, postoperative scrotum edema in 5 cases, self-improvement after scrotal elevation. 2 ~ 5 days after discharge. Follow-up 1 month to 1 year after surgery, no recurrence and testicular retraction. Conclusions The occult hernia of children is relatively high, which can be put into laparoscopic contralateral side of hernia sac and treated at the same time, which can reduce the umbilical incision exploration, reduce the pain of re-anesthesia and operation and reduce the medical cost.