Woodford Evangeline, Eliezer Dilharan, Deshpande Aniruddh, Kumar Rajendra
Department of Paediatric Surgery, John Hunter Children's Hospital, Newcastle, Australia.
Department of Paediatric Surgery, John Hunter Children's Hospital, Newcastle, Australia; University of Newcastle, Priority Research Centre GrowUpWell, Newcastle, Australia.
J Pediatr Surg. 2018 Dec;53(12):2495-2497. doi: 10.1016/j.jpedsurg.2018.08.011. Epub 2018 Sep 2.
BACKGROUND/PURPOSE: Vanishing Testes Syndrome (VTS) is one of the most common causes of impalpable testes in children. The role of removal of testicular nubbins owing to malignant potential in VTS is unclear. We sought to evaluate whether testicular nubbins need to be excised owing to this potential.
We conducted a retrospective review of children with a clinical diagnosis of impalpable testes aged 0-18 who presented to our tertiary hospital between 2007 and 2017. VTS was defined as the presence of hypoplastic vas entering a closed internal inguinal ring or remnants of gonadal tissue distally. Data collected included: age at operation, need for laparoscopy, location of nubbin and histopathological findings.
We identified 50 consecutive children (mean age 2.4 years, range: 7 months to 12 years) with a clinical diagnosis of impalpable testis. Forty-eight of the 50 underwent laparoscopy with no testicle palpable when examined under anesthesia. Thirty-three children had VTS confirmed at laparoscopy and testicular nubbins identified with three of these being bilateral. Thirty-two children had these nubbins excised with histopathology available for 31 individual testes. Thirty were confirmed testicular nubbins with no viable testicular tissue. No malignancies were identified.
Results from this study show that testicular nubbins do not have viable germ cells and therefore do not need to be excised on the basis of malignant potential of residual testicular tissue.
Level IV treatment study.
背景/目的：隐睾综合征（VTS）是儿童睾丸无法触及的最常见原因之一。因VTS中存在恶性潜能而切除睾丸残端的作用尚不清楚。我们试图评估由于这种潜能睾丸残端是否需要切除。
我们对2007年至2017年间在我们三级医院就诊的0 - 18岁临床诊断为睾丸无法触及的儿童进行了回顾性研究。VTS定义为存在发育不全的输精管进入闭合的内环或远端性腺组织残余。收集的数据包括：手术年龄、是否需要腹腔镜检查、残端位置和组织病理学结果。
我们确定了50例连续的临床诊断为睾丸无法触及的儿童（平均年龄2.4岁，范围：7个月至12岁）。50例中的48例接受了腹腔镜检查，麻醉下检查时未触及睾丸。33例儿童在腹腔镜检查时确诊为VTS并发现睾丸残端，其中3例为双侧。32例儿童切除了这些残端，31个睾丸有组织病理学检查结果。30个被确认为睾丸残端，无存活的睾丸组织。未发现恶性肿瘤。
本研究结果表明，睾丸残端没有存活的生殖细胞，因此无需基于残留睾丸组织的恶性潜能进行切除。
IV级治疗研究。
