Department of Pediatric Urology, Children's Healthcare of Atlanta-Emory University School of Medicine, Atlanta, Georgia, USA.
J Urol. 2011 Jun;185(6 Suppl):2451-4. doi: 10.1016/j.juro.2011.01.010. Epub 2011 Apr 28.
The surgical approach to palpable and nonpalpable testicles has changed with increasing use of a single scrotal incision and laparoscopy, respectively. We identified current trends in the surgical approach to undescended testicles in the practice of a single surgeon at our institution.
A total of 580 orchiopexies were performed in 554 patients by a single surgeon between January 2002 and July 2009. Study inclusion criteria were palpable and nonpalpable primary undescended testicles. Patients were stratified into groups based on the date of the initial procedure by year. A retrospective chart review was performed and the surgical approach in each patient was recorded as laparoscopic, transinguinal abdominal, inguinal or scrotal.
During the 7-year period the percent of orchiopexies performed through a single scrotal incision increased from approximately 15% to a high of 63%. The overall percent of cases performed through a standard inguinal incision decreased from 65% to 17% and the percent performed through a transinguinal abdominal approach decreased from 15% to 0% in the 2 most recent years tabulated. The use of laparoscopy increased from 3% to 17%.
Substantial trends were observed among the 3 groups. The percent of procedures performed through a scrotal incision increased during the 7-year period while the percent of inguinal and transinguinal abdominal procedures decreased concomitantly with no increase in morbidity. Selected use of scrotal approach orchiopexy is safe and effective for palpable undescended testicles.
随着经阴囊切口和腹腔镜检查的应用越来越广泛，触及和未触及睾丸的手术入路也发生了变化。我们确定了本院单名外科医生手术治疗未降睾丸的当前趋势。
2002 年 1 月至 2009 年 7 月，一位外科医生共对 554 例患者的 580 例隐睾进行了手术。本研究的纳入标准为可触及和不可触及的原发性隐睾。根据手术初始日期，将患者分为不同年份的组。对患者的病历进行回顾性分析，记录每位患者的手术方法，包括腹腔镜、经腹股沟腹部、腹股沟或阴囊。
在 7 年期间，经单一阴囊切口进行的隐睾固定术的比例从约 15%增加到了 63%的高峰。通过标准腹股沟切口进行的手术的总体比例从 65%下降到了 17%，在最近 2 年中，经经腹股沟腹部途径进行的手术比例从 15%下降到了 0%。腹腔镜的使用比例从 3%增加到了 17%。
在这 3 组中观察到了显著的趋势。在 7 年期间，通过阴囊切口进行的手术比例增加，而腹股沟和经腹股沟腹部手术的比例同时下降，且发病率没有增加。选择使用阴囊入路进行隐睾固定术对于可触及的未降睾丸是安全有效的。
