单孔腹腔镜治疗小儿鞘膜积液疗效及复发病例治疗分析

张岗1 ，杨增雷1 ，郭涛2，白安胜1，徐泉1

（1. 西北妇女儿童医院小儿外科，陕西 西安，710061；2. 西安市儿童医院泌尿外科，陕西 西安，710003）

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摘要：

目的 探讨小儿鞘膜积液经单孔腹腔镜治疗后的效果，对复发患儿再次进行治疗并探讨复发原因。方法 选择我院2011年1月至2015年1月收治的650例鞘膜积液患儿，所有患儿均在单孔腹腔镜下，采用自制带线并勾线一体针行鞘状突结扎术，观察患儿的治疗效果。术后随访3~18个月，观察患儿的复发情况，并分析其复发原因。结果 650例患儿的单孔腹腔镜手术均顺利完成，均未出现严重并发症，术后外观满意。其中，隐性内环口未闭168例。术后3个月内，5例患儿出现复发，复发率为0.8%，5例复发患儿再次手术治疗，且手术均顺利完成，术中发现原结扎线鞘状突漏扎4 例，线结松脱1 例。结论 单孔腹腔镜下鞘状突高位结扎术治疗小儿鞘膜积液安全、有效，创伤小，操作简便，值得推广。复发患儿主要因手术操作引起，因此进一步提高操作技巧、改进穿刺针，可提高手术成功率。

关键词：腹腔镜；鞘膜积液；小儿；复发

中图分类号：R726.5文献标志码：A文章编号：2096-1413(2017)21-0084-02

Treatment effect of laparoendoscopic single-site surgery for pediatric hydrocele and treatment analysis of relapse cases
ZHANG Gang 1, YANG Zeng-lei 1, GUO Tao 2, BAI An-sheng 1, XU Quan 1
(1. Department of Pediatric Surgery, Northwest Women and Children``s Hospital, Xi``an 710061; 2. Department of Urology Surgery,

Xi``an Children``s Hospital, Xi``an 710003, China)

ABSTRACT: Objective To investigate the effect of laparoendoscopic single -site surgery for pediatric hydrocele, and explore the causes of relapse cases after the second treatment. Methods From January 2011 to January 2015, 650 cases of children with hydrocele were selected and performed laparoendoscopic single-site surgery with the needle of self-made line and hook line. The children were followed up for 3-18 months, the recurrence of the children was observed and the causes of relapse cases were analyzed. Results Six hundred and fifty cases all successfully completed the laparoendoscopic single-site surgery, and there was no serious complications, with the satisfactary postoperative appearance. Of which the 168 cases were found with recessive inner ring unclosed. Three months after surgery, 5 cases of children recurred, and the recurrence rate was 0.8%. These 5 cases underwent the re-operation, and successfully completed surgeries. The surgery found that the original ligation of processus vaginalis did not completely close in 4 cases, 1 case of loose knot. Conclusion High ligation under laparoendoscopic single-site surgery is safe, effective, slightly traumatic, and easy to operate, which is worthy of promotion. Recurrence of children mainly caused by operation, so further improving the operating skills and the puncture needle can improve the success rate of surgery.
KEYWORDS: laparoscopy; hydrocele; children; recrudescence

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