Gutiérrez Dueñas J M, Lorenzo G, Ardela Díaz E, Martin Pinto F, Domínguez Vallejo F J
Servicio de Cirugía Pediátrica, Complejo Asistencial de Burgos, Avenida del Cid Campeador, 96.09005 Burgos.
Cir Pediatr. 2011 Apr;24(2):79-83.
We present our first results with the technique described by Bianchi and Squire in 1989 for the surgical treatment of undescended testis by scrotal incision as an alternative to the traditional inguinal approach.
Prospective study of patients operated with the diagnosis of cryptorchidism with scrotal orchidopexy from October 2008 through July 2009.
patients with inguinal palpable testis, scrotal orchidopexy, testicular position was assessed at 6 months and/or one year after surgery. All procedures were performed by the same surgeon. Retractile testes were excluded. We studied the preoperative localization of the testis, the average surgical time, presence or absence of the processus vaginalis, conversions to the traditional inguinal orchiopexy, complications and location of six months and one year after surgery.
A total of 50 orchidopexy were performed in 39 patients during this period. Aged between 1 and 12 years (mean 5 years, median 4 years). Were located in the intraoperative exam under anesthesia, fifteen testes in the inguinal canal and 35 in the external inguinal ring. Operative times ranged from 15 to 60 minutes (mean 34 minutes). The processus vaginalis was patent in 25 procedures (50%) and were ligated via the scrotal incision. Two patients required conversion to a traditional inguinal approach. All testes were satisfactorily positioned in the scrotum and there were no cases de testicular atrophy or ascent, hernia o hydrocele formation with followup that ranged from 6 months to 1 year.
The technique of orchiopexy with scrotal approach is a safe, well tolerated and reliable method.
我们展示了采用1989年比安奇和斯奎尔所描述的技术，通过阴囊切口对隐睾进行手术治疗的首批结果，以此作为传统腹股沟入路的替代方法。
对2008年10月至2009年7月间因隐睾诊断而接受阴囊睾丸固定术的患者进行前瞻性研究。
腹股沟可触及睾丸、阴囊睾丸固定术的患者，术后6个月和/或1年评估睾丸位置。所有手术均由同一位外科医生进行。回缩性睾丸被排除。我们研究了术前睾丸定位、平均手术时间、鞘状突是否存在、转为传统腹股沟睾丸固定术的情况、并发症以及术后6个月和1年时的位置。
在此期间，39例患者共进行了50例睾丸固定术。年龄在1至12岁之间（平均5岁，中位数4岁）。在麻醉下术中检查发现，15个睾丸位于腹股沟管，35个位于腹股沟外环。手术时间为15至60分钟（平均34分钟）。25例手术（50%）鞘状突开放，通过阴囊切口结扎。2例患者需要转为传统腹股沟入路。所有睾丸在阴囊中位置满意，随访6个月至1年期间，未出现睾丸萎缩、上移、疝或鞘膜积液形成的病例。
阴囊入路睾丸固定术是一种安全、耐受性良好且可靠的方法。
