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腹腔内睾丸的管理:世界小儿外科医师协会联合会(WOFAPS)实践调查

The Management of Intraabdominal Testis: A Survey of the World Federation of Associations of Pediatric Surgeons (WOFAPS) Practices.

作者信息

Shehata Sameh, Hadziselimovic Faruk, Khater Doaa, Kotb Mostafa

机构信息

Department of Pediatric Surgery, Alexandria Faculty of Medicine, Alexandria, Egypt.

Department of Pediatrics, Children's Day Care Center Liestal, Cryptorchidism Research Institute, Liestal, Switzerland.

出版信息

Front Pediatr. 2022 Jun 29;10:928069. doi: 10.3389/fped.2022.928069. eCollection 2022.

Abstract

BACKGROUND AND OBJECTIVE

The optimal treatment protocol of intraabdominal testis is still a matter of debate and until now there are a lot of areas of controversy as regards this challenging subtype. The aim of this report is to document current practice patterns among surgeons from different continents through an online Redcap survey supervised the World Federation of the Association of Pediatric Surgeons (WOFAPS).

METHODS

A 16-question-survey related to the management of intraabdominal testis was created and administered RedCap. The WOFAPS headquarters sent an email to all members inviting voluntary survey participation. Data were entered using Microsoft EXCEL spreadsheet and analyzed. Descriptive statistics were performed for each survey item.

RESULTS

There were 436 WOFAPS members who participated in this study with a response rate of 29%, and the vast majority were pediatric surgeons. Only 13% tried to use hormone therapy aiming to induce testicular descent or to improve future fertility. The choices of various surgical techniques were noted. During laparoscopy, if vessels and cord structure were seen entering the ipsilateral internal inguinal ring, most respondents chose to explore the groin. On the other hand, should there was an absent or atrophic testis, the respondents were split on whether to perform a contralateral orchiopexy.

CONCLUSION

This survey describes the current practices of a sample of pediatric surgeons and urologists in the management of intraabdominal testis. The use of hormonal treatment, timing of fixation and management in case of passing through vas and vessels through DIR were undisputable. However, management of low-lying and peeing testis together with the management of contralateral testis were still debatable.

摘要

背景与目的

腹腔内睾丸的最佳治疗方案仍存在争议,迄今为止,针对这一具有挑战性的亚型,仍有许多争议领域。本报告的目的是通过一项由世界小儿外科医师协会联合会(WOFAPS)监督的在线Redcap调查,记录来自不同大洲的外科医生目前的实践模式。

方法

创建了一项与腹腔内睾丸管理相关的包含16个问题的调查问卷,并通过RedCap进行发放。WOFAPS总部向所有成员发送电子邮件,邀请他们自愿参与调查。数据使用Microsoft EXCEL电子表格录入并进行分析。对每个调查项目进行描述性统计。

结果

有436名WOFAPS成员参与了本研究,回复率为29%,绝大多数是小儿外科医生。只有13%的人尝试使用激素疗法,旨在诱导睾丸下降或改善未来生育能力。记录了各种手术技术的选择情况。在腹腔镜检查中,如果看到血管和精索结构进入同侧腹股沟内环,大多数受访者选择探查腹股沟。另一方面,如果睾丸缺失或萎缩,受访者对于是否进行对侧睾丸固定术存在分歧。

结论

本调查描述了小儿外科医生和泌尿外科医生样本在腹腔内睾丸管理方面的当前实践。激素治疗的使用、固定时机以及在输精管和血管通过腹股沟管内环时的处理是无可争议的。然而,低位睾丸和回缩睾丸的处理以及对侧睾丸的处理仍存在争议。

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