Department of Urology, Anhui Provincial Children's Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China.
J Laparoendosc Adv Surg Tech A. 2024 Jul;34(7):664-669. doi: 10.1089/lap.2023.0361. Epub 2023 Nov 20.
This study aimed to compare the clinical outcomes of two surgical approaches, laparoscopic-assisted scrotal incision and conventional inguinal-scrotal incision, for treating cryptorchidism with unobliterated processus vaginalis. Clinical data from 60 pediatric patients with inguinal cryptorchidism who were admitted to our institution between January 2018 and January 2022 were retrospectively analyzed. Depending on the surgical technique used, the patients were split into two groups: the laparoscopic group ( = 30) underwent a laparoscopic-assisted scrotal incision, whereas the conventional group ( = 30) underwent a conventional inguinal-scrotal incision for testicular descent and fixation. The length of the procedure, intraoperative blood loss, and the typical hospital stay following the procedure were compared between the two groups. Also assessed was the frequency of postoperative complications including wound infection and hematoma development. The laparoscopic group demonstrated a notably shortened average surgical duration compared with the traditional group, and this discrepancy held statistical significance ( = .017). Moreover, the laparoscopic approach resulted in a reduced volume of intraoperative blood loss, with a statistically significant distinction ( = .002), along with a decreased average length of hospital stay after surgery, also statistically significant ( = .009). Testicular retraction, atrophy, inguinal hernias, or hydrocele were not present in any group. Although the difference between the laparoscopic and open groups was not statistically significant ( > .05), the laparoscopic group saw a reduced frequency of scrotal hematoma. The frequency of wound infection was also decreased in the laparoscopic group compared with the open group, although there was no statistically significant difference ( > .05). The laparoscopic-assisted scrotal incision approach for testicular descent and fixation offers precise localization of cryptorchidism, reduced surgical trauma, shorter postoperative recovery time, and results in smaller scars with minimal tissue damage. The procedure showcases enhanced overall clinical effectiveness, fewer postoperative complications, heightened safety, and superior cosmetic outcomes.
本研究旨在比较两种手术方式(腹腔镜辅助阴囊切开术和传统腹股沟-阴囊切开术)治疗未闭鞘状突的隐睾症的临床疗效。回顾性分析 2018 年 1 月至 2022 年 1 月我院收治的 60 例腹股沟隐睾症患儿的临床资料。根据手术方式的不同,将患儿分为两组:腹腔镜组(n=30)行腹腔镜辅助阴囊切开术,传统组(n=30)行传统腹股沟-阴囊切开术行睾丸下降固定术。比较两组患者的手术时间、术中出血量及术后典型住院时间。还评估了术后并发症的发生率,包括伤口感染和血肿形成。与传统组相比,腹腔镜组的平均手术时间明显缩短,差异具有统计学意义(P=0.017)。此外,腹腔镜组术中出血量减少,差异具有统计学意义(P=0.002),术后平均住院时间缩短,差异具有统计学意义(P=0.009)。两组均无睾丸回缩、萎缩、腹股沟疝或鞘膜积液。虽然腹腔镜组与开放组之间的差异无统计学意义(P>0.05),但腹腔镜组阴囊血肿的发生率较低。与开放组相比,腹腔镜组的伤口感染发生率也有所降低,但差异无统计学意义(P>0.05)。腹腔镜辅助阴囊切开术治疗隐睾症可准确定位隐睾症,减少手术创伤,缩短术后恢复时间,且疤痕较小,组织损伤小。该手术具有更好的整体临床效果,更少的术后并发症,更高的安全性和更好的美容效果。