Joshi Nachiket Milind, Shah Rasik Shamji
Department of General Surgery, Worthing Hospital, Worthing, UK.
Department of General Surgery, P. D. Hinduja National Hospital and MRC, Mumbai, Maharashtra, India.
J Indian Assoc Pediatr Surg. 2024 Jan-Feb;29(1):39-42. doi: 10.4103/jiaps.jiaps_46_23. Epub 2024 Jan 12.
The aim of this study was to objectively assess the long-term results of laparoscopic orchidopexy in patients who were diagnosed clinically to have nonpalpable undescended testis (UDT).
All operated cases of nonpalpable UDT from January, 2000, to January, 2014, were reviewed. After informed consent, all patients were subjected to a color Doppler ultrasound examination to assess the location of the testis, its size, blood supply, and consistency. The size of the testis, operated and nonoperated, was noted down in volume using the formula of 0.71 × length × breath × height.
A total of 114 patients could be identified, who had undergone laparoscopy for nonpalpable UDT in the study period. Of these, 44 patients (54 units) underwent a color Doppler study to assess the testes. All the testes were found to lie in the scrotum with preserved blood supply. The volume of the operated unilateral testes (mean = 1.605 cm) was smaller than the normal nonoperated side (mean = 2.524 cm). The smaller testicular volume was observed in spite of maintained blood supply to the testes. In cases of bilateral UDT, both the testes were smaller in size (mean = 2.2 cm), but were comparable to each other. In addition, the ultrasound examination revealed the presence of normal homogenous parenchyma of all the testes similar to the nonoperated side.
Laparoscopic orchidopexy is a safe and effective option in the treatment of nonpalpable UDT. On a long-term basis, it is possible to achieve scrotal position along with preserved blood flow following laparoscopic orchidopexy in all patients suffering from nonpalpable UDT.
本研究的目的是客观评估临床诊断为不可触及隐睾(UDT)患者行腹腔镜睾丸下降固定术的长期效果。
回顾2000年1月至2014年1月期间所有不可触及UDT的手术病例。在获得知情同意后,所有患者均接受彩色多普勒超声检查,以评估睾丸的位置、大小、血供和质地。使用0.71×长×宽×高的公式记录手术侧和非手术侧睾丸的体积。
在研究期间,共识别出114例因不可触及UDT接受腹腔镜检查的患者。其中,44例患者(54个睾丸)接受了彩色多普勒检查以评估睾丸。所有睾丸均位于阴囊内,血供良好。手术侧单侧睾丸的体积(平均 = 1.605 cm)小于正常非手术侧(平均 = 2.524 cm)。尽管睾丸血供得以维持,但仍观察到睾丸体积较小。在双侧UDT病例中,两侧睾丸体积均较小(平均 = 2.2 cm),但彼此相当。此外,超声检查显示所有睾丸的实质均正常且均匀,与非手术侧相似。
腹腔镜睾丸下降固定术是治疗不可触及UDT的一种安全有效的选择。从长期来看,所有不可触及UDT的患者在接受腹腔镜睾丸下降固定术后,有可能使睾丸降至阴囊并保持血流。