Koschel Samantha G, Wong Lih-Ming
Department of Urology, St. Vincent's Hospital Melbourne, Melbourne, Australia.
Department of Surgery, University of Melbourne, Melbourne, Australia.
Transl Androl Urol. 2020 Dec;9(6):3094-3102. doi: 10.21037/tau.2019.12.20.
Radical inguinal orchidectomy with division of the spermatic cord at the internal inguinal ring is the gold standard for diagnosis and local treatment of testicular malignancies. The technique is well established and described in detail in this paper, collating methods from various surgical textbooks and articles. We also discuss pre-operative considerations including fertility counselling and potential testicular prosthesis at time of orchidectomy, and the importance of contemplating differential diagnoses such as para-testicular sarcoma and primary testicular lymphoma (PTL) prior to performing radical orchidectomy (RO). The evidence and indications for new surgical techniques to treat local testicular malignancies are also described, including testis sparing surgery (TSS) and spermatic cord sparing orchidectomy.
经腹股沟根治性睾丸切除术，于腹股沟内环处切断精索，是睾丸恶性肿瘤诊断及局部治疗的金标准。该技术已成熟，本文详细描述了其操作方法，整理自各种外科教科书及文章。我们还讨论了术前注意事项，包括生育咨询以及睾丸切除时潜在的睾丸假体，以及在进行根治性睾丸切除术（RO）之前考虑鉴别诊断如睾丸旁肉瘤和原发性睾丸淋巴瘤（PTL）的重要性。文中还描述了治疗局部睾丸恶性肿瘤的新手术技术的证据及适应证，包括保留睾丸手术（TSS）和保留精索睾丸切除术。
