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腹腔镜经脐治疗少儿婴儿腹股沟疝

Transumbilical endoscopic surgery for incarcerated inguinal hernias in infants and children.

腹腔镜经脐治疗少儿婴儿腹股沟疝

Abstract摘要

PURPOSE:目的

To describe transumbilical laparoscopic herniorrhaphy after unsuccessful attempted manual reduction of incarcerated inguinal hernias in infants and children.

描述采用腹腔镜经脐治疗少儿婴儿难复性腹股沟疝

METHODS:方法

In our two hospitals, two-trocar transumbilical endoscopic surgery (TUES) is the standard technique used to repair incarcerated inguinal hernias in infants and children. Seventeen patients (aged 8months to 2.5years; median, 15months; 15 boys, 2 girls) with incarcerated inguinal hernias underwent urgent laparoscopy after unsuccessful attempted manual reduction. Two 3- or 5-mm trocars were inserted into the abdomen through two intraumbilical incisions, under laparoscopic guidance. The hernia was reduced by combined external manual pressure and internal pulling with bowel forceps. After inspection of the bowel, a round needle with a 2-0 nonabsorbable suture was introduced into the peritoneal cavity through the anterior abdominal wall near the internal inguinal ring. The hernial orifice was closed with an extraperitoneal purse-string suture around the internal inguinal ring, and tied with an intraperitoneal knot.

两家医院,采用两孔标准术式治疗婴幼儿少年腹股沟疝。17个病人(8个月到2.5年中位年龄15个月,15男,2女)在手法失败后采用急诊手术,两个35mmtrocar被插入腹腔。采用外部辅助和腔内拖剥的方式剥离疝囊,检查肠管后。一根园针不可吸收的缝线被引入腹膜腔。经腹腔在内环口周围荷包缝合疝环口。

RESULTS:结果

The TUES procedure was successful in all patients. No conversions to open surgery were required. The mean operating time was 30min (range, 25-40min). All patients were discharged on the second postoperative day. No complications such as postoperative bleeding, hydrocele, or scrotal edema were observed. The mean follow-up period was 15months. No cases of testicular atrophy, hypotrophy, or hernia recurrence were reported.

所有病例获得成功。没有中专手术病例。中位时间30分钟,所有病人均在术后第二日出院,没有出血,鞘膜积液。阴囊水肿病例。中位随访时间为15个月。没有睾丸萎缩及疝复发病例。

CONCLUSIONS:结论

Our preliminary experience with using TUES for the treatment of incarcerated inguinal hernias in infants and children had satisfactory outcomes. This technique appeared to be safe, effective, and reliable, and had excellent cosmetic results.

我们的初步经验是TUES治疗婴幼儿疝气效果是令人满意的。此项技术是安全,有效,可行的方法

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