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围产期睾丸扭转的管理:两个三级医疗中心的经验

Management of perinatal testicular torsion: experience of two tertiary centers.

作者信息

Yağız Beytullah, Hancıoğlu Sertaç, Balcı Özlem, Demirel Berat Dilek, Karaman Ayşe, Bıçakcı Ünal, Özgüner İsmet Faruk, Karaman İbrahim

机构信息

Divison of Pediatric Urology, Department of Pediatric Surgery, Ondokuz Mayıs University School of Medicine, Ondokuz Mayıs Üniversitesi Kurupelit Kampüsü, 55200, Atakum, Samsun, Turkey.

Department of Pediatric Surgery, Ondokuz Mayıs University School of Medicine, Ondokuz Mayıs Üniversitesi Kurupelit Kampüsü, 55200, Atakum, Samsun, Turkey.

出版信息

Pediatr Surg Int. 2020 Aug;36(8):959-963. doi: 10.1007/s00383-020-04666-4. Epub 2020 May 13.

Abstract

PURPOSE

Perinatal testicular torsion is a rare condition in which testicular salvage rates are significantly low and management is controversial. We retrospectively evaluated our patients and aimed to go through our management approach.

METHODS

The newborn patients who underwent surgery for testicular torsion in two tertiary referral centers between 2000 and 2019 are enrolled. Radiological and clinical findings are retrospectively evaluated.

RESULTS

Thirty-two newborns are enrolled in the study. All of the cases were unilateral and 30 ended up with immediate orchidectomy while 2 received orchidopexy but both underwent atrophy on follow-up. No bilateral torsion is demonstrated neither in 16 patients with bilateral exploration nor in the follow up of the rest 16 with unilateral exploration. Intravaginal torsion was encountered in five patients (16%). No morbidity or mortality related to anesthesia is documented. No malignancy is encountered in any of the patients.

CONCLUSION

Although ipsilateral testicular salvage rates are low, urgent bilateral exploration in a multidisciplinary center seems reasonable to give a chance to the ipsilateral testis and to avoid the rare but catastrophic bilateral torsion, after discussing with the family.

摘要

目的

围产期睾丸扭转是一种罕见病症,睾丸挽救率极低,治疗存在争议。我们对患者进行了回顾性评估,旨在梳理我们的治疗方法。

方法

纳入2000年至2019年间在两家三级转诊中心接受睾丸扭转手术的新生儿患者。对影像学和临床检查结果进行回顾性评估。

结果

32名新生儿纳入研究。所有病例均为单侧,30例最终立即进行了睾丸切除术,2例接受了睾丸固定术,但随访时均出现萎缩。在16例行双侧探查的患者以及其余16例行单侧探查的患者随访中,均未发现双侧扭转情况。5例患者(16%)出现鞘膜内扭转。未记录到与麻醉相关的发病率或死亡率。所有患者均未发现恶性肿瘤。

结论

尽管同侧睾丸挽救率较低,但在多学科中心进行紧急双侧探查,在与家属讨论后,似乎是合理的,以便给同侧睾丸一个机会,并避免罕见但灾难性的双侧扭转。

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