I. Disease characteristics.
1. Pediatric syringomyelia is formed when the congenital sphincter is not closed and fluid accumulates in the sphincter cavity. Inflammation and trauma can also lead to syringomyelia. The disease is characterized by the appearance of a mass in the scrotum and groin, which cannot disappear completely by squeezing, and B ultrasound can confirm the diagnosis of the disease.
2. Sphingomyelomeningocele formed by unclosed sphincter is often due to gradual flow of fluid into the abdominal cavity and smaller cysts when resting flat. In syringomyelia caused by inflammation and trauma, the cysts do not change in size due to rest.
3. This disease is common in boys and rare in girls, and is the most common disease in pediatric surgery. Syringomyelia can appear both on the right side and on the left side, and bilateral lesions are rare. Sometimes it can be found that a patient with a syringomyelia on the right side, soon after completing surgical treatment, appears again on the left side, but, of course, this is still a rare occurrence.
The dangers of this disease: the higher amount of fluid in the sphincter cavity increases the internal pressure, leading to testicular ischemia and poor testicular spermatogenesis, which may lead to infertility or testicular dysplasia.
This disease has a self-healing condition.
Second, preoperative preparation
1.No infectious diseases, such as: cold, pneumonia, diarrhea, etc.; no cough, chronic constipation.
2.The skin of the operation area needs to be washed before the operation.
Third, the risk of surgery
1.Risk of anesthesia;
2.Intraoperative and postoperative bleeding (usually very little bleeding, only 2-3 ml);
3, wound infection, delayed healing;
4, postoperative recurrence (almost no recurrence);
5. Postoperative scrotal swelling: edema or hematoma. (edema often disappears in 1 week, hematoma is rare, and absorption time often takes about 1 month).
IV. Surgical method – sphincter high ligation
Optimal age for surgery: 1 year old or older. If the mass has high tension, the age for surgery is earlier and the surgery can be performed as early as possible.
Non-emergency surgery: A transverse incision of about 1 cm in length is made in the inguinal region and the hernia sac is ligated in a high position. The incision is cosmetically sutured and no suture removal is required. The hospital stay is 3-4 days. Rural cooperative medical care and urban residents’ insurance can reimburse 50% of the cost in our hospital. The total cost is about 2200 RMB.
V. Post-operative precautions
1. Disinfect the wound with complex iodine and change the band-aid every two days after discharge. On the seventh day after surgery, remove the band-aid and take a bath.
2.Rest for 2 weeks (preferably in bed) and reduce exercise, especially strenuous exercise, for six months, which can be beneficial to wound healing.
3.Postoperative attention should be paid to respiratory infections (such as coughing due to cold and pneumonia); avoid carrying heavy objects (children); avoid violent crying and quarreling.
4.Postoperative nutrition can be strengthened (to improve the condition of malnutrition) to enhance the physical fitness of children. Keep the bowel movement smooth and prevent constipation.
5. You can come to the hospital for follow-up after 2 months after discharge.