门诊睾丸固定术是提高隐睾男孩及时修复率的潜在解决方案：一项对4972例病例的8年回顾性研究。

Ambulatory Orchidopexy Is a Potential Solution to Improve the Rate of Timely Repair in Cryptorchid Boys: An 8 Year Retrospective Study of 4,972 Cases.

作者信息

Zhao Tianxin, Deng Fuming, Jia Wei, Gao Xiaofeng, Li Zhongmin, Tang Xiangliang, Li Dian, Zhou Rui, Shu Fangpeng, Zhang Jin, Zhang Zhengtao, Fu Wen, Liu Guochang

机构信息

Department of Pediatric Urology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.

Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.

出版信息

Front Pediatr. 2021 May 4;9:671578. doi: 10.3389/fped.2021.671578. eCollection 2021.

DOI:10.3389/fped.2021.671578

PMID:34017811

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8129512/

Abstract

Cryptorchidism is the most common congenital anomaly in pediatric urology. Although early surgery on cryptorchid boys is recommended by pediatric urologists worldwide, the actual age at orchidopexy is often older than the recommended age. Our medical center has started performing ambulatory orchidopexy since March 2016 at the ambulatory surgery center. We aimed to investigate whether ambulatory orchidopexy can improve the timely repair rate. A retrospective analysis was conducted from 2012 to 2019 at our medical center. Ambulatory orchidopexy was started at our medical center on March 24, 2016. Boys born on or after September 24, 2015 were classified into the "with ambulatory medical resource" group, and boys born before September 24, 2014, were classified into the "without ambulatory medical resource" group. The timely repair rates were calculated and compared. A total of 4,972 cryptorchidism cases were included in the final study. Approximately 33.0% of cryptorchid boys received timely surgery (orchidopexy by the age of 18 months), and only 6.8% of all cryptorchid boys underwent surgery before the age of 1 year. After the performance of ambulatory orchidopexy, the timely repair rate increased from 25.7 to 37.0% ( < 0.001), and the percentage of patients receiving surgery before the age of 1 year increased significantly from 3.5 to 8.6% ( < 0.001). The proportion of timely repair in patients with ambulatory medical resources was significantly higher than that in patients without ambulatory medical resources (15.6% vs. 58.2%, < 0.001). Significant changes in the rate of surgery before 12 months of age were also found between the two groups (2.4% vs. 14.8%, < 0.001). After the performance of ambulatory orchidopexy in our medical center, the rates of both timely repair and receiving surgery before the age of 1 year increased significantly. Ambulatory orchidopexy is a potential solution to improve the rate of timely repair in cryptorchid boys, and it is worthy of promotion in developing countries and regions.

摘要

隐睾症是小儿泌尿外科最常见的先天性异常。尽管全球小儿泌尿外科医生都建议对隐睾患儿尽早进行手术，但实际进行睾丸固定术的年龄往往大于推荐年龄。自2016年3月起，我们的医疗中心开始在门诊手术中心开展门诊睾丸固定术。我们旨在调查门诊睾丸固定术是否能提高及时修复率。2012年至2019年在我们医疗中心进行了一项回顾性分析。我们医疗中心于2016年3月24日开始开展门诊睾丸固定术。2015年9月24日及以后出生的男孩被归入“有门诊医疗资源”组，2014年9月24日之前出生的男孩被归入“无门诊医疗资源”组。计算并比较及时修复率。最终研究共纳入4972例隐睾症病例。约33.0%的隐睾男孩接受了及时手术（18个月龄前进行睾丸固定术），而所有隐睾男孩中只有6.8%在1岁前接受了手术。开展门诊睾丸固定术后，及时修复率从25.7%提高到37.0%（<0.001），1岁前接受手术的患者比例从3.5%显著增加到8.6%（<0.001）。有门诊医疗资源患者的及时修复比例显著高于无门诊医疗资源的患者（15.6%对58.2%，<0.001）。两组在12个月龄前的手术率也有显著变化（2.4%对14.8%，<0.001）。我们医疗中心开展门诊睾丸固定术后，及时修复率和1岁前接受手术的比例均显著提高。门诊睾丸固定术是提高隐睾男孩及时修复率的一种潜在解决方案，值得在发展中国家和地区推广。