Haj M, Shasha S M, Loberant N, Farhadian H
Department of Surgery, Western Galilee Hospital, Nahariya, Israel.
Eur Surg Res. 2007;39(3):160-9. doi: 10.1159/000100473. Epub 2007 Mar 5.
Testicular damage due to ischemia during torsion is aggravated after reduction and reperfusion. The severity of the damage depends on the degree and duration of the torsion. Hypothermia has been successfully used in preserving the viability of ischemic organs for a prolonged period. Our aim is to evaluate the effect of external scrotal cooling in preserving testicular viability after spermatic cord torsion in rats.
100 adult male Sprague-Dawley rats were equally divided into ten groups. Exposure of the right testicle for either 4 or 8 h in groups 1 and 2 were the control groups. The rats in eight groups (3-10) underwent clockwise torsion of 1,080 degrees of the right testis around its longitudinal axis, for either 4 or 8 h. External scrotal cooling was applied during the torsion period in four groups. Half of the rats were sacrificed at the end of the torsion period, while the other rats underwent detorsion and were sacrificed 2 weeks later. All testicles were excised for histology.
The histological results showed that external scrotal cooling decreased both immediate and late damage to the testis, caused by torsion. A moderate degree of injury was found in the contralateral testicle in rats after torsion of the right testicle for 8 h with application of external cooling and detorsion.
External scrotal cooling is effective in preserving the viability of the torsed testis in rats. The injury of ischemia-reperfusion, although reduced by external cooling, may endanger the contralateral testis as well, if the duration of torsion is longer than 4 h. With increased duration of torsion, orchiectomy should be considered. Application of this treatment may reduce the injury in humans awaiting surgery.
睾丸扭转时因缺血导致的睾丸损伤在复位和再灌注后会加重。损伤的严重程度取决于扭转的程度和持续时间。低温已成功用于长时间保存缺血器官的活力。我们的目的是评估阴囊外部降温对大鼠精索扭转后睾丸活力的保护作用。
100只成年雄性Sprague-Dawley大鼠平均分为十组。第1组和第2组中右侧睾丸暴露4或8小时作为对照组。八组（3 - 10组）大鼠右侧睾丸绕其纵轴顺时针扭转1080度，持续4或8小时。四组在扭转期间进行阴囊外部降温。一半大鼠在扭转期结束时处死，另一半大鼠进行扭转复位，2周后处死。所有睾丸均切除用于组织学检查。
组织学结果表明，阴囊外部降温可减轻扭转对睾丸造成的即时和晚期损伤。在右侧睾丸扭转8小时并进行外部降温及扭转复位的大鼠中，对侧睾丸发现有中度损伤。
阴囊外部降温对保护大鼠扭转睾丸的活力有效。缺血再灌注损伤虽因外部降温而减轻，但如果扭转持续时间超过4小时，可能也会危及对侧睾丸。随着扭转持续时间增加，应考虑进行睾丸切除术。应用这种治疗方法可能会减轻等待手术的患者的损伤。
