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与先天性脐膨出患儿隐睾相关的临床因素。

Clinical factors related to undescended testis in infants with gastroschisis.

机构信息

Department of Pediatric Surgery, Osaka Women's and Children's Hospital, Izumi, Japan.

出版信息

Pediatr Int. 2022 Jan;64(1):e15054. doi: 10.1111/ped.15054.

DOI:10.1111/ped.15054
PMID:34743387
Abstract

BACKGROUND

Recent studies have reported the high incidence of undescended testis (UDT) in patients with gastroschisis. Although various mechanical, hormonal, and genetic theories have been postulated to describe testicular descent, the mechanism contributing to this condition remains controversial. We aimed to investigate the incidence and risk factors of UDT in infants with gastroschisis.

METHODS

Male neonates who underwent surgery for gastroschisis between January 1982 and December 2019 were enrolled. Data were analyzed regarding the prevalence of UDT, including spontaneous testicular descent and the necessity of orchidopexy. Patients were grouped into those with or without UDT to identify the risk factors for UDT.

RESULTS

Among 38 patients with gastroschisis, six (15.8%) developed UDT. There were no significant differences in gestational age or birthweight between patients with and without UDT. The patients with UDT had a significantly larger defect size than those without UDT (P = 0.037). In addition, the timing of abdominal closure was significantly later in patients with UDT than in those without UDT (P = 0.004). None of the patients with UDT exhibited spontaneous testicular descent requiring subsequent orchidopexy.

CONCLUSIONS

Patients with gastroschisis had a high prevalence of UDT. In gastroschisis, the incidence of UDT was related to the defect size and the timing of abdominal wall closure, indicating that an insufficient increase in intra-abdominal pressure during the fetal period may affect the development of UDT.

摘要

背景

最近的研究报告称,腹裂患儿中隐睾症(UDT)的发病率很高。尽管已经提出了各种机械、激素和遗传理论来描述睾丸下降,但导致这种情况的机制仍存在争议。我们旨在研究腹裂患儿 UDT 的发生率和危险因素。

方法

纳入 1982 年 1 月至 2019 年 12 月期间接受手术治疗的男性腹裂新生儿。分析 UDT 的发生率和相关数据,包括自发性睾丸下降和是否需要进行睾丸固定术。将患者分为有 UDT 组和无 UDT 组,以确定 UDT 的危险因素。

结果

38 例腹裂患儿中,有 6 例(15.8%)发生 UDT。有 UDT 组和无 UDT 组的患儿在胎龄或出生体重方面无显著差异。有 UDT 组患儿的缺陷大小明显大于无 UDT 组(P=0.037)。此外,有 UDT 组患儿的腹部关闭时间明显晚于无 UDT 组(P=0.004)。无 UDT 组患儿均未出现自发性睾丸下降,无需随后进行睾丸固定术。

结论

腹裂患儿 UDT 的发生率较高。在腹裂中,UDT 的发生率与缺陷大小和腹壁关闭时间有关,这表明胎儿期腹内压增加不足可能影响 UDT 的发育。

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引用本文的文献

1
Analysis of factors associated with undescended testis in patients with congenital diaphragmatic hernia.分析与先天性膈疝患者隐睾相关的因素。
Pediatr Surg Int. 2023 Sep 17;39(1):273. doi: 10.1007/s00383-023-05553-4.