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

Video：

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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.	吳在德, 吳肇漢. 外科學. 北京: 人民衛生出版社, 2010: 413-414.
2.	李炳, 劉樹立, 陳衛兵, 等. 腹腔鏡治療小嬰兒腹股溝斜疝 79 例體會. 中華小兒外科雜志, 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.	王勁, 鄧順鋼, 葉亮, 等. 微型腹腔鏡下小兒腹股溝疝高扎術的改良研究. 臨床小兒外科雜志, 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. 高頻超聲診斷小兒鞘膜積液的臨床應用價值. 中國實用醫藥, 2009, 4(26): 79-80.
9.	余曉琴, 湯正端, 劉勇, 等. 高頻彩超在陰囊疾病中的診斷價值. 實用臨床醫學, 2006, 7(10): 171-172.
10.	馬玉坤, 楊臨洪, 陳麗成, 等. 雙側隱睪患兒術后生育能力的遠期隨訪. 中華小兒外科雜志, 2010, 31(4): 252-254.
11.	聶梅蘭, 陳剛, 吳璇昭. 嬰幼兒嵌頓疝治療體會. 重慶醫學, 2010, 39(20): 2785-2786.
12.	尉遲今新, 劉暢, 張國志. 臍部切口腹腔鏡與下腹橫紋小切口手術治療小兒腹股溝斜疝對比研究. 河北醫學, 2015, 21(10): 1701-1703.
13.	翟勇, 于家祥, 蔣東旭, 等. 經下腹橫紋小切口治療小兒腹股溝疝的臨床體會. 吉林醫學, 2011,32(2): 301.
14.	周崇高, 鄒嬋娟, 李碧香, 等. 腹橫紋小切口治療女嬰腹股溝嵌頓疝 22 例臨床療效分析. 醫學臨床研究, 2016, 33(5): 879-880.
15.	江洪濤, 劉增欽, 郭吉楠, 等. 醫源性輸精管損傷致梗阻性無精子癥的診斷和外科治療. 中華泌尿外科雜志, 2016, 37(1): 52-56.
16.	陳革, 唐健雄. 腹股溝疝術后并發癥處理及預防. 臨床外科雜志, 2012, 20(6): 388-390.
17.	鄭向欣, 管小青, 吳驥, 等. 腹腔鏡下帶線氣腹針治療小兒腹股溝斜疝的應用價值. 中國普外基礎與臨床雜志, 2015, 22(4): 468-471.
18.	胡天平, 郭呂. 隱匿性腹股溝疝的診斷和治療. 中華疝和腹壁外科雜志(電子版), 2011, 5(2): 216-220.
19.	湯明生, 李建宏, 張鏇, 等. 小兒隱匿性腹股溝斜疝的診療進展. 實用兒科臨床雜志, 2012, 27(11): 884-886.
20.	馬杜豐, 周家德. 腹腔鏡下疝囊高位結扎術治療嬰幼兒腹股溝疝的臨床療效. 微創醫學, 2016, 11(1): 31-32, 38.
21.	段光琦, 張敏, 管肖浩. 單孔腹腔鏡治療小兒腹股溝斜疝 55 例分析. 中華疝和腹壁外科雜志(電子版), 2013, 7(3): 255-257.
22.	侯崇智, 卞軍, 施偉棟, 等. 腹腔鏡下單通道自制疝氣針完全腹膜外疝囊高位結扎術治療小兒腹股溝斜疝163例. 中國微創外科雜志, 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.	朱信強, 丁闖, 張明, 等. 腹腔鏡下經皮腹膜外疝囊高位結扎術治療學齡前兒童腹股溝斜疝的臨床效果分析. 中國普外基礎與臨床雜志, 2015, 22(3): 348-350.
27.	李索林, 劉琳, 楊曉鋒. 腹腔鏡技術診治小兒腹股溝斜疝的現狀與評價. 中華小兒外科雜志, 2014, 35(6): 406-409.
28.	莫麗平, 馮繼峰. 嬰兒腹腔鏡疝囊高位結扎手術的麻醉臨床研究. 齊齊哈爾醫學院學報, 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.	王開振, 任為, 時德. 腹股溝疝復發相關性分析. 中華疝和腹壁外科雜志(電子版), 2013, 7(1): 28-31.
31.	夏東亮, 張麗華, 李慶浩, 等. 單孔腹腔鏡和雪橇針治療兒童腹股溝斜疝手術經驗與技巧. 中華疝和腹壁外科雜志(電子版), 2014, 8(3): 265-270.

1. 吳在德, 吳肇漢. 外科學. 北京: 人民衛生出版社, 2010: 413-414.
2. 李炳, 劉樹立, 陳衛兵, 等. 腹腔鏡治療小嬰兒腹股溝斜疝 79 例體會. 中華小兒外科雜志, 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. 王勁, 鄧順鋼, 葉亮, 等. 微型腹腔鏡下小兒腹股溝疝高扎術的改良研究. 臨床小兒外科雜志, 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. 高頻超聲診斷小兒鞘膜積液的臨床應用價值. 中國實用醫藥, 2009, 4(26): 79-80.
9. 余曉琴, 湯正端, 劉勇, 等. 高頻彩超在陰囊疾病中的診斷價值. 實用臨床醫學, 2006, 7(10): 171-172.
10. 馬玉坤, 楊臨洪, 陳麗成, 等. 雙側隱睪患兒術后生育能力的遠期隨訪. 中華小兒外科雜志, 2010, 31(4): 252-254.
11. 聶梅蘭, 陳剛, 吳璇昭. 嬰幼兒嵌頓疝治療體會. 重慶醫學, 2010, 39(20): 2785-2786.
12. 尉遲今新, 劉暢, 張國志. 臍部切口腹腔鏡與下腹橫紋小切口手術治療小兒腹股溝斜疝對比研究. 河北醫學, 2015, 21(10): 1701-1703.
13. 翟勇, 于家祥, 蔣東旭, 等. 經下腹橫紋小切口治療小兒腹股溝疝的臨床體會. 吉林醫學, 2011,32(2): 301.
14. 周崇高, 鄒嬋娟, 李碧香, 等. 腹橫紋小切口治療女嬰腹股溝嵌頓疝 22 例臨床療效分析. 醫學臨床研究, 2016, 33(5): 879-880.
15. 江洪濤, 劉增欽, 郭吉楠, 等. 醫源性輸精管損傷致梗阻性無精子癥的診斷和外科治療. 中華泌尿外科雜志, 2016, 37(1): 52-56.
16. 陳革, 唐健雄. 腹股溝疝術后并發癥處理及預防. 臨床外科雜志, 2012, 20(6): 388-390.
17. 鄭向欣, 管小青, 吳驥, 等. 腹腔鏡下帶線氣腹針治療小兒腹股溝斜疝的應用價值. 中國普外基礎與臨床雜志, 2015, 22(4): 468-471.
18. 胡天平, 郭呂. 隱匿性腹股溝疝的診斷和治療. 中華疝和腹壁外科雜志(電子版), 2011, 5(2): 216-220.
19. 湯明生, 李建宏, 張鏇, 等. 小兒隱匿性腹股溝斜疝的診療進展. 實用兒科臨床雜志, 2012, 27(11): 884-886.
20. 馬杜豐, 周家德. 腹腔鏡下疝囊高位結扎術治療嬰幼兒腹股溝疝的臨床療效. 微創醫學, 2016, 11(1): 31-32, 38.
21. 段光琦, 張敏, 管肖浩. 單孔腹腔鏡治療小兒腹股溝斜疝 55 例分析. 中華疝和腹壁外科雜志(電子版), 2013, 7(3): 255-257.
22. 侯崇智, 卞軍, 施偉棟, 等. 腹腔鏡下單通道自制疝氣針完全腹膜外疝囊高位結扎術治療小兒腹股溝斜疝163例. 中國微創外科雜志, 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. 朱信強, 丁闖, 張明, 等. 腹腔鏡下經皮腹膜外疝囊高位結扎術治療學齡前兒童腹股溝斜疝的臨床效果分析. 中國普外基礎與臨床雜志, 2015, 22(3): 348-350.
27. 李索林, 劉琳, 楊曉鋒. 腹腔鏡技術診治小兒腹股溝斜疝的現狀與評價. 中華小兒外科雜志, 2014, 35(6): 406-409.
28. 莫麗平, 馮繼峰. 嬰兒腹腔鏡疝囊高位結扎手術的麻醉臨床研究. 齊齊哈爾醫學院學報, 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. 王開振, 任為, 時德. 腹股溝疝復發相關性分析. 中華疝和腹壁外科雜志(電子版), 2013, 7(1): 28-31.
31. 夏東亮, 張麗華, 李慶浩, 等. 單孔腹腔鏡和雪橇針治療兒童腹股溝斜疝手術經驗與技巧. 中華疝和腹壁外科雜志(電子版), 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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