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经阴囊睾丸固定术治疗可触及的隐睾:随访与结果

Transscrotal orchidopexy for palpable cryptorchid testis: follow-up and outcomes.

作者信息

Papparella Alfonso, Cobellis Giovanni, De Rosa Laura, Noviello Carmine

机构信息

Pediatric Surgery, Department of Women, Children, General, and Specialist Surgery, Campania University "Luigi Vanvitelli", Naples.

Pediatric Surgery, Salesi Children's Hospital, Marche Polytechnic University, Ancona.

出版信息

Pediatr Med Chir. 2018 Oct 3;40(2). doi: 10.4081/pmc.2018.191.

Abstract

We retrospectively reviewed the results of transscrotal orchidopexy in the surgical management of palpable testis. From January 2014 to June 2017, 130 male children with a total of 140 palpable undescended testes (UDT) underwent transscrotal orchidopexy. The charts were retrospectively reviewed for demographic data, preoperative position and mobility of the testis, patency of the peritoneal vaginal duct (PVD), and post-operative complications. The resting position of the testis and its traction towards the scrotum were assessed before surgery and under anaesthesia. The mean age of the patients was 4.6 years. The position of the testis assessed at surgery was in most cases at the external inguinal ring (62.8%), at the neck of the scrotum (15.7%), in the inguinal canal (12.8%), or in an ectopic position (8,5%). A PVD was found in 66 testes (47.1%). Two surgical cases required an inguinal incision. In each patient, the postoperative course was unremarkable. The testicle at 1-year follow-up was in a scrotal position in 134 cases, but 6 patients required a second surgical intervention for re-ascent of the testis. No testicular atrophy or inguinal hernias were observed. Transscrotal orchidopexy is a simple and effective procedure for the treatment of palpable UDT. The incidence of complications is low and manageable, with rapid postoperative recovery and early resumption of normal activities.

摘要

我们回顾性分析了经阴囊睾丸固定术治疗可触及睾丸的手术效果。2014年1月至2017年6月,130例男童共140个可触及的隐睾接受了经阴囊睾丸固定术。对病历进行回顾性分析,记录人口统计学数据、术前睾丸位置及活动度、腹膜鞘状突(PVD)通畅情况和术后并发症。在手术前和麻醉状态下评估睾丸的静止位置及其向阴囊的牵引情况。患者的平均年龄为4.6岁。手术中评估的睾丸位置大多数位于腹股沟外环(62.8%)、阴囊颈部(15.7%)、腹股沟管(12.8%)或异位位置(8.5%)。66个睾丸(47.1%)发现有PVD。2例手术需要腹股沟切口。每位患者术后过程均无异常。1年随访时,134例患者的睾丸位于阴囊内,但6例患者需要再次手术以使睾丸复位。未观察到睾丸萎缩或腹股沟疝。经阴囊睾丸固定术是治疗可触及隐睾的一种简单有效的方法。并发症发生率低且易于处理,术后恢复快,能早期恢复正常活动。

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