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隐睾的外科治疗及随访

Surgical treatment and follow up on undescended testis.

作者信息

Thorup Jorgen, Cortes Dina

机构信息

Department of Pediatric Surgery 4272, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark.

出版信息

Pediatr Endocrinol Rev. 2009 Sep;7(1):38-43.

Abstract

With skill and ability to control a variety of operative techniques, undescended testes can be placed in the scrotum with 90% success rate in palpable testes and 85% in abdominal testes. Long term results are related also to the variability of the disease. A hypothesis that in cryptorchid testes a common etiologic antenatal factor is associated with infertility and/or testicular malignancy is supported by the finding of the influence of maternal lifestyle factors on fertility, a relative cancer risk of OR: 2.0 in contralateral descended testis of unilateral cryptorchidism, impaired germ cell number at birth in some cryptorchid testes and Intratubular Germ Cell Neoplasia seen in early childhood. The hypothesis that the abnormal location of the testis exposes the testis to infertility and malignant transformation is supported by the findings of early treatment lowering the risk of both infertility and testicular cancer. Disrupted endocrine regulation may be combined with both hypotheses.

摘要

凭借控制各种手术技术的技能和能力,对于可触及的隐睾,将其放入阴囊的成功率为90%,对于腹腔内隐睾,成功率为85%。长期结果也与该疾病的变异性有关。一种假说认为,隐睾中常见的产前病因因素与不育和/或睾丸恶性肿瘤有关,这一假说得到了以下发现的支持:母亲生活方式因素对生育能力的影响、单侧隐睾对侧下降睾丸的相对癌症风险(比值比:2.0)、一些隐睾在出生时生殖细胞数量受损以及儿童早期出现的管内生殖细胞瘤。早期治疗可降低不育和睾丸癌风险的研究结果支持了另一种假说,即睾丸的异常位置使其面临不育和恶性转化的风险。内分泌调节紊乱可能与这两种假说都有关。

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