Chandrasekharam V V S S
Rainbow Children's Hospital, Hyderabad, Andhra Pradesh, India.
Indian J Pediatr. 2005 Dec;72(12):1021-3. doi: 10.1007/BF02724403.
The optimal initial surgical approach for nonpalpable undescended testis (UDT) is debated. The aim of the present study is to compare the results of initial laparoscopy and inguinal exploration in the management of unilateral nonpalpable undescended testes.
The results of 20 children with unilateral nonpalpable UDT managed by initial laparoscopy (group I) were compared with 20 age-matched children managed by inguinal exploration (group II). The location of testes and results of orchiopexy were compared in both groups. A single surgeon performed all the operative procedures.
The majority of testes (16/20 group I, 17/20 group II) in both groups were canalicular or low abdominal. Vanishing testes accounted for one-third (13/40) of the testes, the majority (85%) of which were located in the inguinal canal. All children were discharged within 24 hours of the operation. The success of orchiopexy at 4-6 weeks post-operatively was 85% and 86% in the two groups respectively. Retrospectively, only 7/40 (18%) of the testes would benefit from laparoscopy.
Initial laparoscopic and inguinal approaches to nonpalpable UDT give comparable results. This report failed to demonstrate any specific advantage of initial laparoscopy in the majority of children with unilateral nonpalpable UDT.
对于不可触及的隐睾（UDT），最佳的初始手术方式存在争议。本研究的目的是比较初始腹腔镜检查和腹股沟探查在单侧不可触及隐睾治疗中的效果。
将20例通过初始腹腔镜检查治疗的单侧不可触及UDT患儿（I组）的结果与20例年龄匹配的通过腹股沟探查治疗的患儿（II组）进行比较。比较两组睾丸的位置及睾丸固定术的结果。所有手术操作均由同一位外科医生进行。
两组中的大多数睾丸（I组16/20，II组17/20）位于腹股沟管或下腹部。睾丸缺如占所有睾丸的三分之一（13/40），其中大多数（85%）位于腹股沟管。所有患儿均在术后24小时内出院。术后4 - 6周时，两组睾丸固定术的成功率分别为85%和86%。回顾性分析显示，仅7/40（18%）的睾丸能从腹腔镜检查中获益。
对于不可触及的UDT，初始腹腔镜检查和腹股沟手术方式的效果相当。本报告未能证明初始腹腔镜检查在大多数单侧不可触及UDT患儿中有任何特定优势。
