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儿童隐睾并扭转的诊断、治疗、结局和治疗延误原因:一家大型儿科医学中心的 16 年回顾性研究。

Diagnosis, treatment, outcome, and reasons for delayed treatment of cryptorchidism with torsion in children: a 16-year retrospective study in a large pediatric medical center.

机构信息

Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400000, China.

Pediatrics Research Institute, Children's Hospital of Chongqing Medical University; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Children's Hospital of Chongqing Medical University, Chongqing 400000, China.

出版信息

Asian J Androl. 2022 Jul-Aug;24(4):386-389. doi: 10.4103/aja202184.

Abstract

We describe and summarize the diagnosis, treatment, and reasons for delayed treatment of children with cryptorchidism torsion in Children's Hospital of Chongqing Medical University. The study included 19 cases of cryptorchidism torsion. The age of the children ranged from 16 days to 12 years (median: 6 years). The interval from diagnosis to surgery varied from 4 h to 16 days (median: 3 days). Ultrasound was performed in all cases. Fifteen cases had cryptorchidism torsion, 2 cases had a soft tissue mass in the inguinal region, and 2 cases had an inguinal/abdominal teratoma. Five cases were treated with an orchidopexy, 12 cases were treated with orchiectomy, and 2 cases received resection of a testicular tumor. The 5 children with an orchidopexy were followed up from 1 month to 7 years (median: 3 years), with 1 child having a testis retraction and no blood supply. Of the 12 children who had an orchiectomy, three had delayed diagnosis due to family unawareness of the condition, while other delays were due to delayed referral from primary care facilities. The relative rarity and insufficient awareness of cryptorchidism torsion resulted in a low rate of testicular salvage. Therefore, hospitals of all levels should be fully aware of cryptorchidism with torsion and ensure a male child's genital system and inguinal region are examined to improve the success rate of testicular salvage.

摘要

我们描述并总结了重庆医科大学儿童医院隐匿性睾丸扭转患儿的诊断、治疗和治疗延误的原因。该研究纳入了 19 例隐匿性睾丸扭转患儿。患儿年龄为 16 天至 12 岁(中位数:6 岁)。从诊断到手术的时间间隔为 4 小时至 16 天(中位数:3 天)。所有病例均行超声检查。15 例诊断为隐匿性睾丸扭转,2 例腹股沟区有软组织肿块,2 例腹股沟/腹部畸胎瘤。5 例行睾丸固定术,12 例行睾丸切除术,2 例行睾丸肿瘤切除术。5 例行睾丸固定术的患儿随访 1 个月至 7 年(中位数:3 年),1 例患儿睾丸回缩,无血供。12 例行睾丸切除术的患儿中,3 例因家庭对病情缺乏认识而延误诊断,其他延误是由于初级医疗机构的转诊延误。隐匿性睾丸扭转的相对罕见性和认识不足导致睾丸挽救率较低。因此,各级医院应充分认识到伴有扭转的隐匿性睾丸扭转,并确保对男童的生殖器和腹股沟区域进行检查,以提高睾丸挽救的成功率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77a4/9295475/5a99df031056/AJA-24-386-g001.jpg

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