CAJ | 학술논문

目的比较腹腔镜与腹股沟斜切口手术治疗小儿嵌顿性腹股沟斜疝的疗效.方法我院2010年3月至2011年8月收治小儿嵌顿性腹股沟斜疝111例,56例采用腹腔镜(腹腔镜组)手术治疗,55例采用腹股沟斜切口(传统手术组)手术治疗,比较两种术式的疗效.结果腹腔镜组:3例麻醉后,手法复位困难,放弃腹腔镜手术.手术时间(31.4±10.2) min；术后通气时间(7.8±2.9)h；住院时间(3.3±1.1)d.所有患儿恢复良好,切口美观,Ⅰ期愈合；术后阴囊或阴唇肿胀轻,无血肿；无粘连性肠梗阻；随访1～15个月无复发.传统手术组；手术时间(40.7±11.6)min;术后通气时间(15.3±2.8)h；住院时(5.8±1.4)d.切口较长；术后阴囊或阴唇肿胀重,7例出现阴囊血肿,3例切口少许渗液,1例感染；随访2～17个月,2例术后复发；8例术后对侧出现疝.结论腹腔镜与传统腹股沟斜切口手术比较,具有切口美观,术后阴囊或阴唇无血肿,可同时处理对侧隐匿性疝,恢复快等优点,是一种安全、可靠、有效的术式.
목적 비교복강경여복고구사절구수술치료소인감돈성복고구사산적료효.방법 아원2010년3월지2011년8월수치소인감돈성복고구사산111례,56례채용복강경(복강경조)수술치료,55례채용복고구사절구(전통수술조)수술치료,비교량충술식적료효.결과 복강경조:3례마취후,수법복위곤난,방기복강경수술.수술시간(31.4±10.2) min；술후통기시간(7.8±2.9)h；주원시간(3.3±1.1)d.소유환인회복량호,절구미관,Ⅰ기유합；술후음낭혹음진종창경,무혈종；무점련성장경조；수방1～15개월무복발.전통수술조；수술시간(40.7±11.6)min;술후통기시간(15.3±2.8)h；주원시(5.8±1.4)d.절구교장；술후음낭혹음진종창중,7례출현음낭혈종,3례절구소허삼액,1례감염；수방2～17개월,2례술후복발；8례술후대측출현산.결론 복강경여전통복고구사절구수술비교,구유절구미관,술후음낭혹음진무혈종,가동시처리대측은닉성산,회복쾌등우점,시일충안전、가고、유효적술식.
Objective To evaluate the safety and efficacy of laparoscopic surgery for the treatment of incarcerated inguinal hernia in children.Methods From March 2010 to June 2011,111 patients with incarcerated inguinal hernia were admitted to this department and underwent surgery.Among them,56 patients were perfortcd laparoscopic surgery,and the other 55 underwent open surgery via inguinal oblique incision.The perioperative perimeters and short term outcome were retrospectively analyzed to compare the safety and efficacy of the 2 procedures.Results On the 3 of the 56 patients with laparoscopic surgery,laparoscopic surgery was converted to open surgery for failed man ual reduction of hernia after anesthesia.The mean operative time was 31.4 ± 10.2 minutes.The mean postoperative ventilation time was 7.8 ± 2.9 hours.The mean length of hospital stay was 3.3 ± 1.1 days.All patients recovered well without any complications.The surgical incision was healed primarily.Less postoperative swelling of the scrotum or labia was notcd,and no hematoma occurred.No reoccurrence of hernia was observed during 1 to 15 months' follow up.OOf the 55 patients underwent open surgery,the mean operative time was 40.7 ± 11.6 minutes.The mean postoperative ventilation time was 15.3 ± 2.8 hours.The mean length of hospital stay was 5.8 ± 1.4 days.The scar appearance of incision was more obvious on the patients with open surgery.More severe postoperative swelling of the scrotum or labia was also noted,and scrotal hematoma occurred on 7 patients.During 2 to 17 months' follow-up,small incision exudate was noted on 3 patients,wound infection on 1,hernia recurrence on 2,occurrence of contralateral hcrnia on 8.Conclusions laparoscopic surgery is a safe,reliable and effective procedure for the treatment of incarcerated inguiual hcrnia in children.