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小儿精索横向异位的临床特征、超声表现及治疗:10 年回顾性研究。

Clinical Characteristics, Ultrasonographic Findings, and Treatment of Pediatric Transverse Testicular Ectopia: A 10-Year Retrospective Review.

机构信息

Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Shenzhen, Guangdong, PR China.

Department of Infectious Disease, Shenzhen Children's Hospital, Shenzhen, Guangdong, PR China.

出版信息

Urology. 2021 Aug;154:249-254. doi: 10.1016/j.urology.2021.01.006. Epub 2021 Jan 14.

DOI:10.1016/j.urology.2021.01.006
PMID:33453196
Abstract

OBJECTIVE

To evaluate the clinical data, ultrasonic features, treatment, and long-term outcome of transverse testicular ectopia (TTE) in children.

METHODS

Children with TTE were enrolled in the study between November 2009 and August 2019 in Shenzhen Children's Hospital in China. Clinical information, including demographic characteristics, clinical manifestations, TTE-associated anomalies, ultrasonographic findings, and surgical procedures, were collected from all patients. Patients were re-evaluated at the end of 4 weeks and 6 months after the operation.

RESULTS

A total of 16 cases were enrolled and underwent surgeries, all patients had undescended testis with contralateral inguinal hernia. The ultrasonic findings showed two testicles in 15 cases and no testes in 1 case. Müllerian ducts remnants were found by laparoscopy in 6 cases or by ultrasound in one case. Sixteen cases were treated with laparoscopy orchidopexy or laparoscopy assisted trans-septal orchidopexy-inguinal exploration. After surgery, 16 patients had both testicles in an orthotopic position and with equal size, with normal blood flow.

CONCLUSION

TTE should be suspected in patients with nonpalpable undescended testis and contralateral inguinal hernia. The contralateral processus vaginalis sac occurs in all cases of TTE. Ultrasonography is essential for an early diagnosis of TTE. Laparoscopy-assisted surgery is safe, effective, and minimally invasive therapy for TTE.

摘要

目的

评估儿童横向睾丸异位(TTE)的临床资料、超声特征、治疗方法和长期预后。

方法

2009 年 11 月至 2019 年 8 月期间,中国深圳儿童医院收治了 TTE 患儿。收集所有患者的临床资料,包括人口统计学特征、临床表现、TTE 相关异常、超声表现和手术过程。所有患者均在术后 4 周和 6 个月时进行复查。

结果

共纳入 16 例患者,均接受了手术治疗,所有患者均为隐睾合并对侧腹股沟疝。超声检查发现 15 例患者有两个睾丸,1 例患者无睾丸。6 例患者通过腹腔镜检查发现苗勒管残迹,1 例患者通过超声检查发现苗勒管残迹。16 例患者均接受了腹腔镜睾丸固定术或腹腔镜辅助经隔睾丸固定术-腹股沟探查术治疗。术后 16 例患者的睾丸均位于正常位置且大小相等,血流正常。

结论

对于触诊不到的隐睾和对侧腹股沟疝患者,应怀疑存在 TTE。所有 TTE 患者的对侧鞘状突均发生。超声检查对于 TTE 的早期诊断至关重要。腹腔镜辅助手术是 TTE 的一种安全、有效、微创的治疗方法。

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