Palacio M M, Sferco A, García Fernanndez A E, Vilarrodona H O
Section of Urology, Children's Hospital, and Private Center of Pediatric Urology, Córdoba, Argentina.
J Pediatr Surg. 1999 Mar;34(3):424-5. doi: 10.1016/s0022-3468(99)90491-8.
BACKGROUND/PURPOSE: A new procedure is described for securing the testis in the scrotum in patients with a past history of inguinal sugery and testes in an unsatisfactory position.
Twenty-seven patients with 29 abnormally positioned testes (two bilateral) were evaluated. All patients had a past history of inguinal surgery, and ages ranged between 4 and 16 years (mean, 7.2). Previous surgical procedures included 23 orchiopexies, 4 inguinal herniorrhaphies, and 2 testicular detorsions of undescended testis. In all reoperations an attempt was made to fix a strip (two nonabsorbable stitches) of the fascia attached to the cord, to the pubic bone, or to the tendinosous part of the gracilis muscles (cordopexy), so that the distal part of the cord and the testis lay freely in the scrotum without tension. Patients underwent follow-up every 6 months after the operation with physical and ultrasound examinations.
Cordopexy was possible in 11 (38%) of the 29 inguinal reoperations. In all cases, orchiopexy was the previous surgical procedure. One hundred percent of the testes remain within the scrotum after a mean follow-up of 21 months (range, 8 to 38).
When feasible, inguinal cordopexy is a simple and effective technique for securing testicles in reoperative orchiopexy procedures.
背景/目的：本文描述了一种新的手术方法，用于将既往有腹股沟手术史且睾丸位置不理想的患者的睾丸固定于阴囊内。
对27例患者（共29个睾丸位置异常，其中2例为双侧）进行了评估。所有患者均有腹股沟手术史，年龄在4至16岁之间（平均7.2岁）。既往手术包括23例睾丸固定术、4例腹股沟疝修补术和2例隐睾扭转复位术。在所有再次手术中，均尝试将附着于精索的一条筋膜（两根不可吸收缝线）固定于耻骨或股薄肌的腱性部分（精索固定术），以使精索远端和睾丸在阴囊内无张力地自由放置。术后每6个月对患者进行随访，包括体格检查和超声检查。
29例腹股沟再次手术中有11例（38%）可行精索固定术。所有病例中，之前的手术均为睾丸固定术。平均随访21个月（8至38个月）后，100%的睾丸仍位于阴囊内。
在可行的情况下，腹股沟精索固定术是再次睾丸固定手术中固定睾丸的一种简单有效的技术。
