Abbas Tariq O, Hayati Ahmed, Ismail Adel, Ali Mansour
Pediatric Surgery Department, Hamad General Hospital, Doha 3050, Qatar.
Minim Invasive Surg. 2012;2012:878509. doi: 10.1155/2012/878509. Epub 2012 Feb 14.
Background. Undescended testis is one of the most common urological problems in children, affecting about 1% of boys at age of 1 year. Of these, about 20% have a nonpalpable testis with a very high probability that the testis is absent. This may have a significant impact on the possibility of malignancy in these testes, as well as on the later fertility of these subjects. Methods. We retrospectively analyzed the demographic and clinical findings, as well as immediate and 6-month outcomes, in 91 patients diagnosed with impalpable undescended testes between January 2006 and December 2010. Results. Of the 91 patients, 9 had bilateral and 82 had unilateral impalpable testes. All 100 testes were managed laparoscopically. The largest group of intra-abdominal testes in this series, 42 testes, was entering the internal ring; in these, laparoscopic exploration and standard open orchiopexy resulted in a 66% success rate. The total success rate was 63.3%. Conclusion. Laparoscopy is extremely useful in both the diagnosis and treatment of impalpable testes. Objectively measured mobility of the testis towards the contralateral internal inguinal ring is an excellent intraoperative indicator for type of orchiopexy. Standardization of management may increase the success rate of orchiopexy.
背景。隐睾是儿童最常见的泌尿外科问题之一,1岁男孩中约1%受其影响。其中,约20%的患儿睾丸不可触及,睾丸缺如的可能性非常高。这可能对这些睾丸发生恶性肿瘤的可能性以及这些患儿日后的生育能力产生重大影响。方法。我们回顾性分析了2006年1月至2010年12月期间91例诊断为不可触及隐睾患儿的人口统计学和临床资料,以及即刻和6个月的预后情况。结果。91例患儿中,9例为双侧不可触及睾丸,82例为单侧不可触及睾丸。所有100个睾丸均采用腹腔镜治疗。本系列中腹腔内睾丸数量最多的一组为42个睾丸,这些睾丸进入内环;对于这些睾丸,腹腔镜探查及标准开放睾丸固定术的成功率为66%。总成功率为63.3%。结论。腹腔镜在不可触及睾丸的诊断和治疗中极为有用。客观测量睾丸向对侧腹股沟内环的活动度是睾丸固定术术式的一个极佳术中指标。管理的标准化可能会提高睾丸固定术的成功率。