Clinical value of laparoscopic high ligation of hernia sac with constructed veress needle in the treatment of indirect inguinal hernia in children_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Jian ^1,2 ,  WU Jianqiang ² , MA Xiaoming ² , ZHAO Mingzuo ² , HUANG Hailong ²

1. Medical School of Nanjing University, Nanjing 210093, P.R.China;
2. Department of General Surgery, Suqian People’s Hospital of Nanjing Drum-Tower Hospital Group, Suqian, Jiangsu 223800, P.R.China;

Corresponding author：

WU Jianqiang, Email: wjq-10@163.com

Keywords：

indirect inguinal hernia; veress needle; laparoscopy; high ligation of hernia sac; child

DOI：

10.7507/1007-9424.201609096

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Objective To investigate the clinical value of laparoscopic high ligation of hernia sac with constructed veress needle in the treatment of indirect inguinal hernia in children. Methods Ninety-one cases of pediatric indirect inguinal hernia who received treatment in Suqian People’s Hospital of Nanjing Drum-Tower Hospital Group from October 2014 to December 2015 were selected and randomly divided into two groups, cases of laparoscopy group (n=41) were treated by laparoscopic high ligation of hernia sac with constructed veress needle, and cases of tradition group (n=50) were treated with traditional open high ligation of hernia sac. Comparison of clinical effect between the 2 groups was performed. Results All the operations were successfully carried out, and there was no conversion to open surgery in laparoscopy group. Three cases were diagnosed as two-side inguinal hernia in laparoscopy group, who were diagnosed as one-side inguinal hernia before operation. The operation time, length of surgical incision, blood loss, and hospital stay of the laparoscopy group were all significantly less than those of the tradition group (P<0.05). The incidence of postoperative complications such as scrotal edema and scrotal hydrocele, incidence of testicular dysplasia, and the recurrence rate in the laparoscopy group were all significantly lower than those of the tradition group (P<0.05). Conclusions Laparoscopic high ligation of hernia sac with constructed veress needle in the treatment of indirect inguinal hernia in children has good application value, which has advantages of small surgical trauma, shorter hospital stay, faster recovery, and less postope-rative complications, and we can find out contralateral recessive hernia during operation and avoid the second surgery.

Citation： WANG Jian, WU Jianqiang, MA Xiaoming, ZHAO Mingzuo, HUANG Hailong. Clinical value of laparoscopic high ligation of hernia sac with constructed veress needle in the treatment of indirect inguinal hernia in children. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(6): 710-715. doi: 10.7507/1007-9424.201609096 Copy

1.	吴在德, 吴肇汉. 外科学. 北京: 人民卫生出版社, 2010: 413-414.
2.	李炳, 刘树立, 陈卫兵, 等. 腹腔镜治疗小婴儿腹股沟斜疝 79 例体会. 中华小儿外科杂志, 2012, 33(1): 70-72.
3.	Shalaby R, Ismail M, Dorgham A, et al. Laparoscopic hernia repair in infancy and childhood: evaluation of 2 different techniques. J Pediatr Surg, 2010, 45(11): 2210-2216.
4.	王劲, 邓顺钢, 叶亮, 等. 微型腹腔镜下小儿腹股沟疝高扎术的改良研究. 临床小儿外科杂志, 2013, 12(5): 403-405.
5.	Parelkar SV, Oak S, Gupta R, et al. Laparoscopic inguinal hernia repair in the pediatric age group——experience with 437 children. J Pediatr Surg, 2010, 45(4): 789-792.
6.	Uchida H, Kawashima H, Goto C, et al. Inguinal hernia repair in children using single-incision laparoscopic-assisted percutaneous extraperitoneal closure. J Pediatr Surg, 2010, 45(12): 2386-2389.
7.	Lee A, Park SJ, Lee HK, et al. Acute idiopathic scrotal edema: ultrasonographic findings at an emergency unit. Eur Radiol, 2009, 19(8): 2075-2080.
8.	王芳. 高频超声诊断小儿鞘膜积液的临床应用价值. 中国实用医药, 2009, 4(26): 79-80.
9.	余晓琴, 汤正端, 刘勇, 等. 高频彩超在阴囊疾病中的诊断价值. 实用临床医学, 2006, 7(10): 171-172.
10.	马玉坤, 杨临洪, 陈丽成, 等. 双侧隐睾患儿术后生育能力的远期随访. 中华小儿外科杂志, 2010, 31(4): 252-254.
11.	聂梅兰, 陈刚, 吴璇昭. 婴幼儿嵌顿疝治疗体会. 重庆医学, 2010, 39(20): 2785-2786.
12.	尉迟今新, 刘畅, 张国志. 脐部切口腹腔镜与下腹横纹小切口手术治疗小儿腹股沟斜疝对比研究. 河北医学, 2015, 21(10): 1701-1703.
13.	翟勇, 于家祥, 蒋东旭, 等. 经下腹横纹小切口治疗小儿腹股沟疝的临床体会. 吉林医学, 2011,32(2): 301.
14.	周崇高, 邹婵娟, 李碧香, 等. 腹横纹小切口治疗女婴腹股沟嵌顿疝 22 例临床疗效分析. 医学临床研究, 2016, 33(5): 879-880.
15.	江洪涛, 刘增钦, 郭吉楠, 等. 医源性输精管损伤致梗阻性无精子症的诊断和外科治疗. 中华泌尿外科杂志, 2016, 37(1): 52-56.
16.	陈革, 唐健雄. 腹股沟疝术后并发症处理及预防. 临床外科杂志, 2012, 20(6): 388-390.
17.	郑向欣, 管小青, 吴骥, 等. 腹腔镜下带线气腹针治疗小儿腹股沟斜疝的应用价值. 中国普外基础与临床杂志, 2015, 22(4): 468-471.
18.	胡天平, 郭吕. 隐匿性腹股沟疝的诊断和治疗. 中华疝和腹壁外科杂志(电子版), 2011, 5(2): 216-220.
19.	汤明生, 李建宏, 张镟, 等. 小儿隐匿性腹股沟斜疝的诊疗进展. 实用儿科临床杂志, 2012, 27(11): 884-886.
20.	马杜丰, 周家德. 腹腔镜下疝囊高位结扎术治疗婴幼儿腹股沟疝的临床疗效. 微创医学, 2016, 11(1): 31-32, 38.
21.	段光琦, 张敏, 管肖浩. 单孔腹腔镜治疗小儿腹股沟斜疝 55 例分析. 中华疝和腹壁外科杂志(电子版), 2013, 7(3): 255-257.
22.	侯崇智, 卞军, 施伟栋, 等. 腹腔镜下单通道自制疝气针完全腹膜外疝囊高位结扎术治疗小儿腹股沟斜疝163例. 中国微创外科杂志, 2014, 14(6): 519-521, 528.
23.	Xu C, Xiang B, Jin SG, et al. Transumbilical two-port laparoscopic percutaneous extraperitoneal closure: a new technique for inguinal hernia repair in children. J Laparoendosc Adv Surg Tech A, 2013, 23(4): 392-396.
24.	Saranga Bharathi R, Arora M, Baskaran V. Minimal access surgery of pediatric inguinal hernias: a review. Surg Endosc, 2008, 22(8): 1751-1762.
25.	Chan KL, Chan HY, Tam PK. Towards a near-zero recurrence rate in laparoscopic inguinal hernia repair for pediatric patients of all ages. J Pediatr Surg, 2007, 42(12): 1993-1997.
26.	朱信强, 丁闯, 张明, 等. 腹腔镜下经皮腹膜外疝囊高位结扎术治疗学龄前儿童腹股沟斜疝的临床效果分析. 中国普外基础与临床杂志, 2015, 22(3): 348-350.
27.	李索林, 刘琳, 杨晓锋. 腹腔镜技术诊治小儿腹股沟斜疝的现状与评价. 中华小儿外科杂志, 2014, 35(6): 406-409.
28.	莫丽平, 冯继峰. 婴儿腹腔镜疝囊高位结扎手术的麻醉临床研究. 齐齐哈尔医学院学报, 2011, 32(18): 2947-2948.
29.	Xu X, Xin G, Peng Z, et al. Low-dose ketamine pretreatment reduces oxidative damage and inflammatory response following CO₂ pneumoperitoneum in rats. Clin Invest Med, 2014, 37(3): E124-E130.
30.	王开振, 任为, 时德. 腹股沟疝复发相关性分析. 中华疝和腹壁外科杂志(电子版), 2013, 7(1): 28-31.
31.	夏东亮, 张丽华, 李庆浩, 等. 单孔腹腔镜和雪橇针治疗儿童腹股沟斜疝手术经验与技巧. 中华疝和腹壁外科杂志(电子版), 2014, 8(3): 265-270.

1. 吴在德, 吴肇汉. 外科学. 北京: 人民卫生出版社, 2010: 413-414.
2. 李炳, 刘树立, 陈卫兵, 等. 腹腔镜治疗小婴儿腹股沟斜疝 79 例体会. 中华小儿外科杂志, 2012, 33(1): 70-72.
3. Shalaby R, Ismail M, Dorgham A, et al. Laparoscopic hernia repair in infancy and childhood: evaluation of 2 different techniques. J Pediatr Surg, 2010, 45(11): 2210-2216.
4. 王劲, 邓顺钢, 叶亮, 等. 微型腹腔镜下小儿腹股沟疝高扎术的改良研究. 临床小儿外科杂志, 2013, 12(5): 403-405.
5. Parelkar SV, Oak S, Gupta R, et al. Laparoscopic inguinal hernia repair in the pediatric age group——experience with 437 children. J Pediatr Surg, 2010, 45(4): 789-792.
6. Uchida H, Kawashima H, Goto C, et al. Inguinal hernia repair in children using single-incision laparoscopic-assisted percutaneous extraperitoneal closure. J Pediatr Surg, 2010, 45(12): 2386-2389.
7. Lee A, Park SJ, Lee HK, et al. Acute idiopathic scrotal edema: ultrasonographic findings at an emergency unit. Eur Radiol, 2009, 19(8): 2075-2080.
8. 王芳. 高频超声诊断小儿鞘膜积液的临床应用价值. 中国实用医药, 2009, 4(26): 79-80.
9. 余晓琴, 汤正端, 刘勇, 等. 高频彩超在阴囊疾病中的诊断价值. 实用临床医学, 2006, 7(10): 171-172.
10. 马玉坤, 杨临洪, 陈丽成, 等. 双侧隐睾患儿术后生育能力的远期随访. 中华小儿外科杂志, 2010, 31(4): 252-254.
11. 聂梅兰, 陈刚, 吴璇昭. 婴幼儿嵌顿疝治疗体会. 重庆医学, 2010, 39(20): 2785-2786.
12. 尉迟今新, 刘畅, 张国志. 脐部切口腹腔镜与下腹横纹小切口手术治疗小儿腹股沟斜疝对比研究. 河北医学, 2015, 21(10): 1701-1703.
13. 翟勇, 于家祥, 蒋东旭, 等. 经下腹横纹小切口治疗小儿腹股沟疝的临床体会. 吉林医学, 2011,32(2): 301.
14. 周崇高, 邹婵娟, 李碧香, 等. 腹横纹小切口治疗女婴腹股沟嵌顿疝 22 例临床疗效分析. 医学临床研究, 2016, 33(5): 879-880.
15. 江洪涛, 刘增钦, 郭吉楠, 等. 医源性输精管损伤致梗阻性无精子症的诊断和外科治疗. 中华泌尿外科杂志, 2016, 37(1): 52-56.
16. 陈革, 唐健雄. 腹股沟疝术后并发症处理及预防. 临床外科杂志, 2012, 20(6): 388-390.
17. 郑向欣, 管小青, 吴骥, 等. 腹腔镜下带线气腹针治疗小儿腹股沟斜疝的应用价值. 中国普外基础与临床杂志, 2015, 22(4): 468-471.
18. 胡天平, 郭吕. 隐匿性腹股沟疝的诊断和治疗. 中华疝和腹壁外科杂志(电子版), 2011, 5(2): 216-220.
19. 汤明生, 李建宏, 张镟, 等. 小儿隐匿性腹股沟斜疝的诊疗进展. 实用儿科临床杂志, 2012, 27(11): 884-886.
20. 马杜丰, 周家德. 腹腔镜下疝囊高位结扎术治疗婴幼儿腹股沟疝的临床疗效. 微创医学, 2016, 11(1): 31-32, 38.
21. 段光琦, 张敏, 管肖浩. 单孔腹腔镜治疗小儿腹股沟斜疝 55 例分析. 中华疝和腹壁外科杂志(电子版), 2013, 7(3): 255-257.
22. 侯崇智, 卞军, 施伟栋, 等. 腹腔镜下单通道自制疝气针完全腹膜外疝囊高位结扎术治疗小儿腹股沟斜疝163例. 中国微创外科杂志, 2014, 14(6): 519-521, 528.
23. Xu C, Xiang B, Jin SG, et al. Transumbilical two-port laparoscopic percutaneous extraperitoneal closure: a new technique for inguinal hernia repair in children. J Laparoendosc Adv Surg Tech A, 2013, 23(4): 392-396.
24. Saranga Bharathi R, Arora M, Baskaran V. Minimal access surgery of pediatric inguinal hernias: a review. Surg Endosc, 2008, 22(8): 1751-1762.
25. Chan KL, Chan HY, Tam PK. Towards a near-zero recurrence rate in laparoscopic inguinal hernia repair for pediatric patients of all ages. J Pediatr Surg, 2007, 42(12): 1993-1997.
26. 朱信强, 丁闯, 张明, 等. 腹腔镜下经皮腹膜外疝囊高位结扎术治疗学龄前儿童腹股沟斜疝的临床效果分析. 中国普外基础与临床杂志, 2015, 22(3): 348-350.
27. 李索林, 刘琳, 杨晓锋. 腹腔镜技术诊治小儿腹股沟斜疝的现状与评价. 中华小儿外科杂志, 2014, 35(6): 406-409.
28. 莫丽平, 冯继峰. 婴儿腹腔镜疝囊高位结扎手术的麻醉临床研究. 齐齐哈尔医学院学报, 2011, 32(18): 2947-2948.
29. Xu X, Xin G, Peng Z, et al. Low-dose ketamine pretreatment reduces oxidative damage and inflammatory response following CO₂ pneumoperitoneum in rats. Clin Invest Med, 2014, 37(3): E124-E130.
30. 王开振, 任为, 时德. 腹股沟疝复发相关性分析. 中华疝和腹壁外科杂志(电子版), 2013, 7(1): 28-31.
31. 夏东亮, 张丽华, 李庆浩, 等. 单孔腹腔镜和雪橇针治疗儿童腹股沟斜疝手术经验与技巧. 中华疝和腹壁外科杂志(电子版), 2014, 8(3): 265-270.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical value of laparoscopic high ligation of hernia sac with constructed veress needle in the treatment of indirect inguinal hernia in children

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