微创医学

【摘要】目的探讨免气腹腹腔镜下隐睾下降固定术治疗小儿隐睾的临床疗效和安全性。方法将62例单侧隐睾症患儿随机分为两组。对照组（30例）给予传统气腹后腹腔镜下隐睾下降固定术，观察组（32例）给予免气腹腹腔镜下隐睾下降固定术。术后比较两组临床疗效和安全性。结果两组手术均获成功。观察组手术时间为(42.5±6.2)min，术中出血量为(4.2±1.4)mL，住院时间为(3.3±0.4)d，与对照组的手术时间(43.8±7.1)min、术中出血量(4.1±1.2)mL、住院时间(3.2±0.4)d比较，差异无统计学意义(P＞0.05)。观察组术后声嘶、咳嗽的发生率为28.1%（9/32），显著低于对照组的63.3%（19/30），两组比较，差异有统计学意义(P＜0.05)。术后随访6～12个月，两组发育情况比较，差异无统计学意义（P＞0.05）。结论免气腹腹腔镜下隐睾下降固定术治疗小儿隐睾具有创伤小、康复快、并发症少的优点，手术效果及安全性与传统气腹腹腔镜下隐睾下降固定术相当。

【Abstract】 ObjectiveTo investigate the clinical efficacy and safety of gasless laparoscopic orchiopexy in children with cryptorchidism. MethodsSixtytwo children with unilateral cryptorchidism were randomly divided into two groups. Retroperitoneal laparoscopic orchiopexy and gasless laparoscopic orchiopexy were conducted in the control group (n=30) and the observation group (n=32) respectively. The clinical efficacy and safety were compared between the two groups after operation. ResultsThe operations were completed successfully in both groups. There were no significant differences in the operative duration, intraoperative blood loss and hospital stay between the observation group ［(42.5±6.2)min, (4.2±1.4)mL and (3.3±0.4)d, respectively］ and the control group ［(43.8±7.1)min, (4.1±1.2)mL and (3.2±0.4)d, respectively］ (P＞0.05). The postoperative incident rate of hoarseness and cough in the observation group was significantly lower than that of the control group ［28.1%(9/32) vs 63.3% (19/30) , P＜0.05］. During postoperative followedup of 6～12 months, there was no significant difference in the development status between the two groups (P＞0.05). ConclusionFor children with cryptorchidism, the gasless laparoscopic orchiopexy has the advantages of less trauma, faster recovery and fewer complications, and obtains similar efficacy and safety as conventional retroperitoneal laparoscopic orchiopexy.