Department of Paediatric Urology, Royal Manchester Children's Hospital, Oxford Road, Manchester, UK.
J Pediatr Urol. 2010 Oct;6(5):506-12. doi: 10.1016/j.jpurol.2009.10.016. Epub 2009 Nov 26.
The role of the transcrotal approach to the undescended testis remains controversial despite its increasing popularity. The authors update their previous published series and review the literature on this subject, aiming to delineate the value of this technique.
The authors performed a retrospective review of the transcrotal primary orchidopexy carried out to treat palpable undescended testis at Royal Manchester Children's Hospital between 1993 and 2005. A structured review of literature published since the proposal of this technique was also performed.
122 procedures were included. The transcrotal approach was successfully completed in 119 (97.5%). Additional groin incision was needed in three (2.5%) to further mobilize the spermatic cord. No immediate complications were recorded and 8.4% required a reoperative procedure. On review of the literature, a total of 16 articles were discovered spanning 1695 transcrotal procedures, including the previously published authors' experience. On combining the data, the transcrotal approach required an additional groin incision in 4.4% of cases, 1.6% experienced immediate and/or early complications, and the overall recurrence rate was 2.0%.
Transcrotal orchidopexy for the treatment of palpable undescended testes is a safe procedure with a long-term success rate comparable to the two-incision approach.
尽管经皮睾丸固定术越来越受欢迎,但对于未降睾丸的经皮途径的作用仍存在争议。作者更新了他们之前发表的系列,并对该主题的文献进行了综述,旨在阐明该技术的价值。
作者对 1993 年至 2005 年间在皇家曼彻斯特儿童医院行经皮睾丸固定术治疗可触及未降睾丸的患者进行了回顾性研究。同时对该技术提出以来发表的文献进行了系统综述。
共纳入 122 例手术。119 例(97.5%)经皮途径手术成功完成。3 例(2.5%)需要进一步的腹股沟切口以进一步游离精索。无即时并发症,8.4%需要再次手术。文献回顾共发现 16 篇文章,共 1695 例经皮睾丸固定术,包括之前作者的经验。综合数据,经皮途径手术有 4.4%需要额外的腹股沟切口,1.6%发生即时和/或早期并发症,总的复发率为 2.0%。
经皮睾丸固定术治疗可触及未降睾丸是一种安全的手术,其长期成功率与两切口手术相当。