Ghnnam Wagih M, Saed Basem, Ghazy Hosam
General Surgery Department, Mansoura Faculty of Medicine, Dakahlia, Egypt.
Afr J Paediatr Surg. 2011 May-Aug;8(2):203-5. doi: 10.4103/0189-6725.86063.
Undescended testes are a common problem, affecting up to 3% of newborn males. The goals of orchiopexy in humans are to provide adequate scrotal fixation, to prevent recurrent torsion of the testis and spermatic cord or ascent of the testis, and to achieve these goals with minimal trauma to the testis. The best method of achieving fixation remains controversial.
The aim of our study is to evaluate our modified extra Dartos pouch technique in retaining testis in the scrotum.
A prospective randomized study included 159 patients with 185 orchiopexies age ranging from 5 months to 14 years with the mean age of 49.5 ± 33.3 months (4.08 years). They were divided into two groups: Group I for whom the extra Dartos pouch technique was applied were compared to Group II for whom classic sub-Dartos pouch technique was done.
Testis was located in the superficial inguinal pouch in 102 cases (64.1%) and intra-canalicular in 57 cases (35.6%). Hernial sac was found in 153 cases (96.2%), postoperative wound infection occurred in 3 cases (1.9%) and hematoma formation in three cases (1.9%); one case reported ascent of the testis and another one had testicular atrophy in the follow-up period which extends now up to 3 years and we are still in follow-up with those cases.
Our modified technique for extra Dartos pouch fixation seems to be a fast reliable method for orchiopexy; however, comparative studies and long-term assessment is still needed to establish this method.
隐睾是一个常见问题，影响多达3%的新生男婴。人类睾丸固定术的目标是实现睾丸在阴囊内的充分固定，防止睾丸和精索反复扭转或睾丸上升，并以对睾丸的最小创伤实现这些目标。实现固定的最佳方法仍存在争议。
我们研究的目的是评估我们改良的额外肉膜囊技术将睾丸保留在阴囊内的效果。
一项前瞻性随机研究纳入了159例患者，共进行了185例睾丸固定术，年龄范围为5个月至14岁，平均年龄为49.5±33.3个月（4.08岁）。他们被分为两组：应用额外肉膜囊技术的第一组与采用经典肉膜囊下技术的第二组进行比较。
102例（64.1%）睾丸位于腹股沟浅袋内，57例（35.6%）位于管内。发现疝囊153例（96.2%），术后伤口感染3例（1.9%），血肿形成3例（1.9%）；1例在随访期（目前已长达3年，我们仍在对这些病例进行随访）报告睾丸上升，另1例出现睾丸萎缩。
我们改良的额外肉膜囊固定技术似乎是一种快速可靠的睾丸固定方法；然而，仍需要进行比较研究和长期评估来确立该方法。
