摘要
目的探讨经脐单穿刺孔腹腔镜治疗小儿鞘膜积液的临床价值，并与经脐及腹侧壁双穿刺孔方法进行比较研究。方法回顾性对比分析2012年1至5月首都儿科研究所附属儿童医院收治的实施腹腔镜下鞘突高位结扎术的鞘膜积液患儿78例，均为男性，其中经脐单穿刺孔腹腔镜（单孔组）32例，经脐及腹侧壁双穿刺孔（双孔组）46例。比较两组手术时间、术后住院时间、术后并发症及费用。结果两组手术均顺利完成，无中转手术。单孔组单侧、双侧手术时间分别为（20±10）、（31±11）min，双孔组单侧、双侧手术时间分别为（20±8）、（29±9）min，差异均无统计学意义（均P〉0．05）。术中单孔组腹腔镜下视野暴露良好，与双孔组视野暴露情况相比无明显差别，仅在视野角度方面，双孔组腹腔镜视野较为灵活。两组患儿术后随访3～6个月，术后均无复发。单孔组、双孔组住院费用分别为（5199±599）和（5117±684）元，差异无统计学意义（P〉0．05）。结论脐部单穿刺孔腹腔镜手术治疗鞘膜积液安全可行，对比双孔法手术时间、术后住院时间、术后并发症及手术费用差异均无统计学意义，仅脐部褶皱一处切口，美容效果满意，且由术者单人操作，节省人力，在小儿外科工作中有重要的临床意义。
Objective To explore the feasibility and clinical efficacies of unbilical one-trocar laparoendoscopie surgery versus trans-umbilicus and abdominal wall two-troear laparoendoscopic surgery in the treatment of pediatric hydrocele. Methods Retrospective comparative analysis was conducted for 78 cases of hydrocele undergoing laparoscopic surgery at our hospital from January 2012 to May 2012. They were divided into two groups of umbilical one-troear laparoseopie surgery （one-trocar, n = 32 ） and transumbilicus and abdominal wall two-trocar laparoscopie surgery （two-trocar, n = 46）. And their profiles of operative duration, post-operative hospital stay and treatment cost were compared. Results All procedures were successful. No case converted into open surgery. Visual field of both methods was similar, but twotrocar group had a flexible visual angle. During a follow-up period of 3 - 6 months, there was no occurrence of postoperative complications. The average operative duration was （20 ± 10 ） min at one side and （31 ± 11 ） min at both sides in one-trocar group versus （20 ± 8 ） min and （29 ± 9） min in two-trocar group. There were no statistical significance （all P 〉 0.05 ）. Cost in one-troear group was （5199 ± 599 ）yuan RMB and （5117 ±684） yuan RMB in two-trocar group （ P 〉 0. 05 ）. Conclusions Trans-umbilicus laparoendoscopic one-trocar surgery is both feasible and safe in the treatment of pediatric hydrocele. Compared with two-trocar laparoscopie surgery, both approaches are similar in terms of operative duration, post-operative hospital stay and treatment cost. Since there is a single hidden navel scar, the former is labor-saving, may be handled by one operator and offers better cosmetic outcomes.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第2期128-131,共4页
National Medical Journal of China
关键词
腹腔镜
睾丸鞘膜积液
儿童
单孔法
Laparoscopes
Testicular hydrocele
Child
Single-hole method
