CAJ | 학술논문

目的：探讨腹腔镜手术在婴幼儿腹股沟嵌顿性斜疝中的临床应用价值。方法2011年2月～2014年2月采用腹腔镜急诊手术治疗婴幼儿腹股沟嵌顿疝62例，气管插管全麻后腹腔镜辅助手法复位，复位失败于腹股沟外环体表投影1．5 cm小切口，松解嵌顿，均行腹腔镜下内环口高位结扎。结果62例均顺利完成腹腔镜手术：腹腔镜辅助复位49例，手术时间（32．4±11．9）min，住院时间（4．3±1．1）d；腹腔镜嵌顿松解13例，手术时间（52．1±15．4）min，住院时间（5．1±1．7）d。无输精管、精索血管损伤，无阴囊血肿、切口感染等并发症。62例随访2～24个月，平均14个月，术后无睾丸萎缩、医源性隐睾、切口疝等并发症，术后复发1例，复发率1．6％（1/62）。结论腹腔镜下可同时发现和处理对侧隐性内环口未闭，腹腔镜手术治疗婴幼儿腹股沟嵌顿性斜疝安全可行，疗效确切。
목적：탐토복강경수술재영유인복고구감돈성사산중적림상응용개치。방법2011년2월～2014년2월채용복강경급진수술치료영유인복고구감돈산62례，기관삽관전마후복강경보조수법복위，복위실패우복고구외배체표투영1．5 cm소절구，송해감돈，균행복강경하내배구고위결찰。결과62례균순리완성복강경수술：복강경보조복위49례，수술시간（32．4±11．9）min，주원시간（4．3±1．1）d；복강경감돈송해13례，수술시간（52．1±15．4）min，주원시간（5．1±1．7）d。무수정관、정색혈관손상，무음낭혈종、절구감염등병발증。62례수방2～24개월，평균14개월，술후무고환위축、의원성은고、절구산등병발증，술후복발1례，복발솔1．6％（1/62）。결론복강경하가동시발현화처리대측은성내배구미폐，복강경수술치료영유인복고구감돈성사산안전가행，료효학절。
Objective To evaluate the clinical value of laparoscopic techniques in the treatment of incarcerated inguinal hernia in infants . Methods The clinical data of 62 infants with incarcerated inguinal hernia between February 2011 and February 2014 treated by emergent laparoscopic surgery was retrospectively analyzed .The operations were performed under general anesthesia with tracheal intubation .After laparoscopic assisted manual reduction , laparoscopic high ligation was carried out .If the reduction failed, a small incision 1.5 cm in length was made in the groin outer surface projection to release the lesion . Results The laparoscopic surgery was successfully performed in all the 62 cases.Laparoscopic assisted reduction was completed in 49 cases, with an operation time of 32.4 ±11.9 min and a mean postoperative hospital stay of 4.3 ±1.1 days.Laparoscopic embedded Bolton loose solution was performed in 13 cases, with an operation time of 52.1 ±15.4 min and a mean postoperative hospital stay of 5.1 ±1.7 days.No seminiferous duct or spermatic vessels injuries were noted .No postoperative scrotal hematoma , incision infections , or other complications happened.All the patients were followed up for 2-24 months (average, 14 months).No testicular atrophy, iatrogenic cryptorchidism, or incisional hernia was observed .Postoperative recurrence was recorded in 1 case, with a recurrence rate of 1.6%(1/62). Conclusions Laparoscopic surgery in the treatment of infantile inguinal strangulated hernia is safe and effective .The procedure is helpful for detecting and dealing with concealed hernia .