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目的探讨经脐两孔腹腔镜联合手术治疗小儿斜疝并脐疝的效果。方法 2008年1月-2011年1月收治斜疝并脐疝患儿9例,均予经脐两孔腹腔镜联合手术治疗。患儿全麻后于脐轮左右侧旁开5 mm各作长约3 mm纵行切口,置入2个5.5 mm Tro-car,先内环口体表投影处刺入带2-0线的改良克氏针,体外打结处理斜疝;后在腹腔镜指引下置入带2-0双丝线改良克氏针,由左Trocar进入右侧Trocar,带出丝线,再从左侧脐部皮下穿入改良克氏针带回丝线,提起脐部结扎丝线,切口医用胶黏合。结果 9例患儿手术均顺利完成,手术时间(20±5)min,住院时间3～5 d[(3.0±0.5)d]。随访3～27个月,均无复发及肠梗阻发生。结论经脐两孔腹腔镜联合手术治疗小儿斜疝并脐疝安全、有效、微创、保脐、美容,有较好的临床应用价值。
Objective To investigate the effect of umbilical two-hole laparoscopic surgery in treating children with hernia and umbilical hernia. Methods From January 2008 to January 2011, 9 children with oblique hernia and umbilical hernia were treated by laparoscopy combined with two holes in umbilicus. After general anesthesia in children with left and right sides of the umbilical cord to open 5 mm each for about 3 mm longitudinal incision, into the two 5.5 mm Tro-car, the first inner ring mouth piercing the body with 2-0 line projection Modified Kirschner wire, tied knot in vitro treatment of lumbar hernia; laparoscopic guide after the placement of 2-0 double wire modified Kirschner wire, left Trocar into the right Trocar, with silk, and then from the left umbilical subcutaneous Wear improved Kirschner wire back to the silk, lifting the umbilical ligation silk, incision medical glue. Results All the 9 cases were successfully performed. The operation time was (20 ± 5) min and the length of stay was 3 ~ 5 days [(3.0 ± 0.5) d]. Follow-up 3 to 27 months, no recurrence and intestinal obstruction occurred. Conclusions The transumbilical laparoscopic combined operation of umbilical two holes in the treatment of children with oblique hernia and umbilical hernia is safe, effective, minimally invasive, Paul navel, cosmetic, has a good clinical value.