小儿腹股沟疝1263例腹腔镜手术并发症分析

摘要

目的 探讨小儿腹股沟疝腹腔镜疝囊高位结扎手术治疗中,不同手术方式对手术并发症的防治体会.方法 收集2003年8月至2012年8月株洲市三三一医院腹腔镜下小儿腹股沟疝疝囊高位结扎手术患儿1 263例病历资料,并进行回顾性分析.根据采用微创手术方法的不同分为研究组(631例)和对照组(632例).对照组采用常规方法,研究组在对照组的基础上通过注射器注水实验,紧贴腹壁下动脉外侧切开腹股沟管,缝合时先环绕输精管一侧腹膜,再环绕精索一侧腹膜,排除阴囊内积气,腹腔镜口可吸收线内翻缝合等方法预防并发症.比较2组患儿复发率和并发症的发生率.结果 研究组和对照组复发率分别为0.3％(2/631)和0.8％(5/632),2组复发率比较差异有统计学意义(P＜0.01).研究组发生血肿2例,并发症发生率为0.3％ (2/631);对照组线结反应2例、血肿4例、切口疝2例,并发症发生率为1.3％(8/632).2组并发症发生率差异有统计学意义(P＜0.01).结论 规范的操作能够最大限度减少腹腔镜下小儿腹股沟斜疝囊高位结扎手术并发症.%Objective To study the complications of laparoscopic operation treating inguinal hernia in children.Methods Pediatric inguinal hernia operation treating 1 263 cases of high ligation of hernial sac were retrospectively analyzed.According to the different operation methods,the patients were divided into the study group (631 cases) and control group (632 cases).The patients in control group received conventional methods.The patients in study group received syringe injection experiments on the basis of the conventional method.Inguinal canal was incised along lateral of inferior epigastric artery.The gas in scrotum inner was ruled out and swiched with absorption line suture method.Recurrence rate and incidence of complications in 2 groups were compared.Results The recurrence rate of the study group and the control group was 0.3％ (2/631)and 0.8％ (5/632) respectively.The difference was statistically significant(P ＜0.01).The 2 cases of hematoma were in study group.There were 2 cases of node reaction,4 cases of hematoma and 2 cases of incisional hernia in control group.The complication rate of 2 groups was 0.3％ (2/631)and 1.3％ (8/632).The difference was statistically significant (P ＜0.01).Conclusion he standardized method of the peritoneoscope hernia sac high position ligation can reduce the operation complications in children with indirect inguinal hernia.