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Objective To explore the reasons and management of early relapse of pediatric acute intussusception after enema reduction. Methods Clinical data of 48 patients with early relapse of pediatric acute intussusception after enema reduction were retrospectively collected and analyzed, especially for X-ray data during enema. Relevant management methods were proposed. Results In the comparison of gender, age, admission time and enema pressure between the early relapse group and non-relapse group of children patients, without statistically significant differences(χ2 all <3.84,P>0.05). However, as for①whether X-ray sign of intestinal obstruction could be seen during diagnosis,②whether intus-suscepted parts could be clearly seen after reduction, ③whether intussuscepted parts became larger after pressure re-lief, and ④inflation of small intestine after reduction compared between the two groups, with statistically significant differences (χ2 all>3.84,P<0.05). Patients in the relapse group were all given a secondary enema reduction. Conclu-sion During early stage after reduction of intussusception by air enema, possibilities of relapse or multiple relapses should still be noticed. Observations of multiple repeated changes of body position during enema and special attention to changes of intussuscepted parts are one of critical factors for reducing relapses and ensuring a success for secondary enema. A secondary air enema can be carried out when mastering the indications.
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Objective To explore the application of mini-laparoscopy in the diagnosis and management of nonpalpable undescended testis in children.Methods 38 cases of impalpabal testes(46 testicular) had been operated by mini-laparoscopy in children with cryptorchidism.Results 38 children with nonpalpable undescended testis (46 testicular) had been operated by mini-laparoscope.Results After laparoscopic exploration,inguinal probe and postoperative pathology,it had been confirmed that 2 testicular were absent,34 testicular were found in high inguinal location,10 testicular were located in intraperitoneal cavity.In addition to the absent testicular,the rest had been performed with mini-laparoscope:one period descent fixation 41 testes,Fowler-Stephens (F-S) installment orchiopexy three testes.Follow-up with side testicular atrophy 2,including one period orchiopexy a testis,F-S installment fixation a testicular; Testicular rebound 1,who had been operated with one phase of testicular descent fixtion.Conclusion For inguinal failed to find the testicular,children with cryptorchidism should be done by laparoscopy because of its positioning accuracy,and most children can do a period drop fixed,but for those really intraperitoneal more exalted person,stage surgery should be needed.Its overall treatment effect is satisfactory and is worth popularizing.
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Objective To study medial umbilical ligament in the prevention of recurrence of indirect inguinal hernia with large sac by laparoscopic treatment in children.Methods The clinical data of 178 cases of indirect inguihal hernia with large sacs in children were retrospectively analyzed.After high suture ligation of the internal ring with pediatric laparoscopy,all of the internal tings were covered with the same side of medial umbilical ligament to further strengthen.Results All cases were discharged from hospital 1～2 days after surgery.No recurrence and no any other complications could be found after following up 3～18 months.Conclusion Pediatric laparoscopic application of medial umbilical ligament to further cover the internal ring could significantly reduce the rate of recurrence for indirect inguinal hernia with large sac.This method of operation waft safe and feasible.It Was worth promoting.
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Objective To study the method, advantage and shortcoming of mini-laparoscopic treatment for indirect inguinal hemia in children. Methods 136 cases with indirect inguinal hernia(right:75cases,left:44 cases,bilateral:17 cases) had been treated by high ligation with mini-laparoscopy. Results The mean operation time was 10 mmin for unilateral hernia and 23 mmin for bilateral hernia. Among 119 cases with unilateral hernia,38 cases had been found with contralateral latent hernia. The mean of postoperative inhospital stay were about 1 ～ 2 day(s). All patients had been followed-up for 3 ～ 12 months,there were only 2 cases recurrence found but no complications was detected.Conclusion Mini-laparoscopic high ligation for indirect inguinal hernia in children is a single, safe, satisfactory, effective,and minimally invasive surgical method.