Genc Abdulkadir, Taneli Fatma, Yilmaz Omer, Turkdogan Peyker, Arslan Oguz Alp, Sencan Aydin, Taneli Can
Department of Pediatric Surgery, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
Scand J Urol Nephrol. 2004;38(5):401-4. doi: 10.1080/00365590410029150.
In two-stage orchidopexy, adhesions formed after the first stage usually cause difficulty during the second operation and may even lead to injury to the testis itself or to the spermatic cord. We investigated whether the use of adhesion-preventing barriers in the abdominal or pelvic region during surgery could lessen adhesions formed during two-stage orchidopexy and thus ease dissection.
The study subjects comprised 21 male, albino, 30-day-old Wistar rats that were divided into three equal groups. In Group 1, the right testes were enveloped in adhesion barriers after dissection and sutured to the inguinal canal. In Group 2, the right testes were sutured to the inguinal canal without the barriers. In Group 3 (sham-operated group), all testes were dissected but no suturing was performed. Rats were sacrificed after 21 days and the ipsilateral testes were harvested.
Dissection of barrier-enveloped testes was relatively easy; however, no significant (p < 0.535) difference was seen in adhesion scores between Groups 1 and 2. Total tissue collagen was estimated by means of the hydroxyproline content. Tissue hydroxyproline levels were 16.04 +/- 8.58, 13.20 +/- 6.34 and 14.71 +/- 5.51 microg/mg wet tissue in Groups 1-3, respectively and these differences were not significant. The histopathologic evaluation revealed significant differences only in the thickness of the tunica albuginea in Groups 1 and 2 (110.0 +/- 30.0 vs 77.1 +/- 21.3 microm, respectively; p < 0.038).
The adhesion scores and the biochemical and histopathological examinations showed that an adhesion barrier is not beneficial in two-stage orchidopexy.
在两期睾丸固定术中，第一期手术后形成的粘连通常会给第二期手术带来困难，甚至可能导致睾丸本身或精索受损。我们研究了手术期间在腹部或盆腔区域使用防粘连屏障是否可以减少两期睾丸固定术中形成的粘连，从而便于解剖。
研究对象为21只30日龄雄性白化Wistar大鼠，平均分为三组。第1组，右侧睾丸在解剖后用粘连屏障包裹，然后缝合至腹股沟管。第2组，右侧睾丸不使用屏障直接缝合至腹股沟管。第3组（假手术组），所有睾丸均进行解剖，但不进行缝合。21天后处死大鼠，摘取同侧睾丸。
解剖包裹有屏障的睾丸相对容易；然而，第1组和第2组之间的粘连评分无显著差异（p < 0.535）。通过羟脯氨酸含量估算总组织胶原蛋白。第1 - 3组的组织羟脯氨酸水平分别为16.04 +/- 8.58、13.20 +/- 6.34和14.71 +/- 5.51微克/毫克湿组织，这些差异不显著。组织病理学评估显示，仅第1组和第2组的白膜厚度存在显著差异（分别为110.0 +/- 30.0微米和77.1 +/- 21.3微米；p < 0.038）。
粘连评分以及生化和组织病理学检查表明两期睾丸固定术中使用粘连屏障并无益处。
