Ferro F, Spagnoli A, Zaccara A, De Vico A, La Sala E
Andrological Surgery Unit, Bambino Gesú Children's Hospital, Rome, Italy.
J Urol. 1999 Sep;162(3 Pt 2):995-6; discussion 997. doi: 10.1016/S0022-5347(01)68044-3.
Laparoscopic assessment of pelvic anatomy has gained wide popularity over the years. Today surgical treatment of impalpable testis is nearly always preceded by diagnostic laparoscopy. The actual role of such a procedure remains undefined. We performed a prospective randomized clinical trial in patients with impalpable testis to evaluate the clinical usefulness of laparoscopy before surgical exploration.
We studied pediatric, age matched patients with impalpable testis who were randomized to group 1-30 who underwent open surgery only and group 2-31 who underwent laparoscopy and open surgery. Anatomical findings, operative procedures, operative time and cost, number of recurrences and testicular volume at followup were then compared in the 2 groups.
There were no statistically significant differences in the 2 groups for any of the considered parameters except operative cost and time, which were significantly higher in the laparoscopy group.
Preoperative laparoscopy does not provide any significant advantage over open surgery for treating impalpable testis.
多年来，腹腔镜评估盆腔解剖结构已广受欢迎。如今，对于无法触及的睾丸进行手术治疗之前，几乎总是先进行诊断性腹腔镜检查。这种检查的实际作用仍不明确。我们对无法触及睾丸的患者进行了一项前瞻性随机临床试验，以评估手术探查前腹腔镜检查的临床实用性。
我们研究了年龄匹配的小儿无法触及睾丸患者，将其随机分为两组，第1组30例仅接受开放手术，第2组31例接受腹腔镜检查及开放手术。然后比较两组的解剖学发现、手术操作、手术时间和费用、复发次数以及随访时的睾丸体积。
除了手术费用和时间外，两组在任何所考虑的参数上均无统计学显著差异，腹腔镜检查组的手术费用和时间显著更高。
术前腹腔镜检查在治疗无法触及的睾丸方面并不比开放手术具有任何显著优势。
