Single-port knotting versus three-port stitching under laparoscopy for treatment of funicular hydrocele in children: comparative study of intestinal mucosal barrier function
Gao Peng, Zhang Xuguang, Shan Yingjun，et al
1.the First Departmentof General Surgery, Harbin Children Hospital, Heilongjiang, Harbin 150010, China; 2. Department of Child Health Care, Harbin Children Hospital, Heilongjiang, Harbin 150010, China; 3. Department of Urology,China-Japan Friendship Hospital, Beijing 100029, China; 4. Department of Pediatric Surgery, the SecondHospital of Hebei Medical University, Hebei, Shijiazhuang 050000, China; 5. Central Laboratory, the SecondHospital of Hebei Medical University, Hebei, Shijiazhuang 050000, China; 6. Department of GerneralSurgery, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China
Abstract: 【Abstract】 Objective To compare the intestinal mucosal barrier function between single-portextracorporeal knotting and three-ports intracorporeal purse-string stitching for treatment of funicular hydrocele in children. Methods From January 2018 to July 2018, the clinical data of 73 children with funicular hydrocele in Harbin Children Hospital were selected and divided into two groups randomly,including 35 cases undertaking three-port intracorporeal purse-string stitching( stitching group) and 38 cases undertaking single-port extracorporeal knotting(knotting group). The clinical data, operation time, anesthesia time, urine ratio of lactulose to mannitol (L/M), serum D-lactic acid and urine intestinal fatty acid binding protein(IFABP) were summarized and compared between the two groups. Results All of the operations were successful conducted. There was no significant difference in age, sex or sides between the two groups (P>0.05). The operation time and anesthesia time had statistical significance between the two groups (P<0.05). And there was no significant difference in urine L/M, serum D-lactic acid or urine IFABP between the two groups before operation (P>0.05). There was no significant difference in urine L/M before operation and 1, 2 d after operation in knotting group (P>0.05), but the urine L/M 1, 2 d after operation were respectively significantly higher than before operation in stitching group (P=0.000). There was no significant difference in serum Dlactic acid before operation and 2 h after operation in knotting group (P>0.05), but the serum D- lactic acid 2 h after operation was significantly higher than before operation in stitching group (P=0.000). There was no significant difference in urine IFABP before operation and 1 d after operation in knotting group (P>0.05), but the urine IFABP 1 d after operation was significantly higher than before operation in stitching group (P=0.000). Conclusions Three-port intracorporeal purse-string stitching and single-port extracorporeal knotting are both safe and feasible for funicular hydrocele in children. Compared with three-port intracorporeal purse-string stitching, the single-port extracorporeal knotting has less influence on intestinal mucosal barrier function.
2020, Vol. 8 
