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目的探讨腹腔镜疝囊高位结扎及脐正中襞覆盖内环口治疗小儿腹股沟斜疝的效果及临床价值。方法 552例小儿腹股沟斜疝患者,按就诊单双日分为对照组和联合组。对照组275例,仅行腹腔镜疝囊高位结扎;联合组277例,腹腔镜疝囊高位结扎后,将脐正中襞覆盖内环口及周围。结果两组手术均顺利完成。对照组和联合组手术时间分别为(12.3±5.5)min 和(20.6±4.2)min(P<0.05),住院时间分别为(2.2±1.5)d 和(2.4±1.3)d(P>0.05),恢复日常活动时间(1.2±0.5)d 和(1.3±0.6)d(P>0.05),复发率为2.2%(6/275)和0(0/277)(P<0.05)。随访22～55个月(平均39.3个月),两组均无腹腔感染、阴囊血肿等并发症。结论腹腔镜疝囊高位结扎及脐正中襞覆盖疝内环口治疗小儿腹股沟疝是安全可行的,具有创伤小、恢复快、不易复发的优点。
Objective To investigate the effect and clinical value of high ligation of laparoscopic hernia sac and intra-umbilicus midliners for inguinal hernia in children. Methods 552 cases of children with inguinal hernia patients, according to the treatment of single-day divided into control group and the combined group. The control group of 275 cases, only laparoscopic high ligation of hernia sac; joint group of 277 cases, laparoscopic high hernia sac ligation, the umbilical mesozoon cover the inner ring mouth and around. Results Both procedures were successfully completed. The operative time in the control group and the combined group were (12.3 ± 5.5) min and (20.6 ± 4.2) min (P <0.05), and the hospital stay was (2.2 ± 1.5) days and (2.4 ± 1.3) days (1.2 ± 0.5) d and (1.3 ± 0.6) d (P> 0.05). The recurrence rate was 2.2% (6/275) and 0 (0/277) respectively (P <0.05). All the patients were followed up for 22-55 months (average 39.3 months). No complications such as abdominal infection and scrotal hematoma were found in both groups. Conclusion High ligation of laparoscopic hernia sac and umbilical midline lumbar hernia in the treatment of infantile inguinal hernia is safe and feasible, with less trauma, rapid recovery, not easy to relapse.