Adam A S, Allaway A J
Royal Alexandra Hospital For Sick Children, Brighton, UK.
BJU Int. 1999 Feb;83(3):290-3. doi: 10.1046/j.1464-410x.1999.00948.x.
To analyse the outcome of using the abdominal pre-peritoneal (APP) approach to orchidopexy.
During an 8-year period, the experience of one surgeon in the management of 553 boys (median age 4.5 years, range 1-13) with undescended testes (596 testes) was assessed. The analysis emphasized those patients who had an orchidopexy performed using the APP approach detailing; the original position of the testis at exploration, whether successful placement within the scrotum was possible, and whether atrophy or ascent of the gonad occurred subsequently.
In 98 boys (110 testes) the testes were impalpable or high within the inguinal canal and they were explored using the APP approach. Of the 34 testes (31%) which were found abdominally, 12 were high intra-abdominal and the remaining 22 just deep to the internal inguinal ring. These included seven bilateral and 20 unilateral intra-abdominal testes. The remaining 76 undescended testes included five with bilateral high testes, 29 high unilateral testes, 13 repeat orchidopexies, 17 'vanishing testis syndrome' and seven atrophic testes. The remaining 486 undescended testes were treated using a standard orchidopexy and were therefore excluded from analysis.
The value and advantages of this operative approach and its place in the management strategy of the difficult orchidopexy are discussed.
分析采用经腹腹膜前（APP）入路进行睾丸固定术的结果。
在8年期间，评估了一位外科医生对553例（中位年龄4.5岁，范围1 - 13岁）隐睾男孩（共596个睾丸）的治疗经验。分析重点关注那些采用APP入路进行睾丸固定术的患者，详细说明探查时睾丸的原始位置、是否有可能成功将其置于阴囊内以及随后性腺是否发生萎缩或上移。
在98例男孩（110个睾丸）中，睾丸无法触及或位于腹股沟管高位，采用APP入路进行探查。在经腹部发现的34个睾丸（31%）中，12个位于腹腔高位，其余22个位于腹股沟内环深部。其中包括7例双侧和20例单侧腹腔内睾丸。其余76个隐睾包括5例双侧高位睾丸、29例单侧高位睾丸、13例再次睾丸固定术、17例“睾丸消失综合征”和7例萎缩性睾丸。其余486个隐睾采用标准睾丸固定术治疗，因此被排除在分析之外。
讨论了这种手术方法的价值和优势及其在困难睾丸固定术治疗策略中的地位。
