目的 比较小儿鞘状突未闭经腹腔镜和开放手术治疗的临床效果.方法 回顾性分析西安市第九医院自2012年1月至2015年12月行鞘状突高位结扎治疗12岁以下小儿腹股沟斜疝和鞘膜积液共92例,其中开放手术组45例,单孔腹腔镜组47例.对两组手术时间、出血量、切口长度、住院时间、治疗费用、切口感染、阴囊水肿、术后复发等情况进行比较分析.结果 两组手术均顺利完成,术后随访3～6月无复发.腹腔镜组术中无中转开放,发现对侧鞘状突未闭9例,单侧手术时间[(21.6±5.6)min vs.(64.5±20.1) min]、平均出血量[(2.1±0.6)vs.(20.0±5.3)mL]、切口长度[(7.2±2.6)mm vs.(36.0±3.9)mm]、住院时间[(5.4±0.5)d]等各指标均少于开放组,而治疗费用[(5 250.22±478.31)元vs.(4 657.19±657.32)元]高于开放组,差异具有统计学意义.结论 单孔腹腔镜下鞘状突高位结扎具有创伤小、住院时间短、可同时发现处理对侧隐性鞘状突未闭以及更为突出的美容效果等特点,值得在有条件的医院开展.%Objective To compare the curative effects of single port laparoscopic percutaneous processus cerclage and open operative high ligation of sheath transverse cutting in the treatment of pediatric patent process vaginal (PPV).MethodsClinical data of 92 cases of pediatric PPV treated during Jan.2012 and Dec.2015 were retrospectively analyzed.The patients were divided into two groups:the laparoscopic group (n =47) which underwent single port laparoscopic percutaneous processus cerclage,and the open group (n =45) which received open operative high ligation of sheath transverse cutting.The operation time,volume of blood loss,incision length,length of hospital stay,cost of treatment,infection of incision,scrotal edema and postoperative relapse of the two groups were compared and analyzed.Results All operations were successful and no recurrence was observed 3-6 months after operation.In the laparoscopic group,no case turned to open operation.Patent vaginal process on contralateral side was observed in 9 cases.The indexes included:unilateral operation time (21.6± 5.6)min,average bleeding volume (2.1±0.6)mL,incision length (7.2-t-2.6) mm,and length of stay (5.4±0.5)d,which were significantly lower than those in the open group,except for the cost (5250.22±478.31) yuan,which was highcr.Conclusion Compared with open surgery,single port laparoscopic percutaneous processus cerclage has the advantages of smaller trauma,shorter hospital stay,easier discovery and dealing of contralateral PPV,and more prominent cosmetic effect.This surgical approach is worth of clinical spread.
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