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腹腔镜与开放或经皮睾丸固定术治疗高位腹股沟未降睾丸的随机临床试验。

Laparoscopic versus open orchiopexy in high inguinal undescended testes, randomized clinical trial.

机构信息

Urology Department, Qena University Hospital, South Valley University, Qena, Egypt.

出版信息

Int Urol Nephrol. 2024 Nov;56(11):3511-3518. doi: 10.1007/s11255-024-04098-2. Epub 2024 Jun 15.

Abstract

BACKGROUND

Traditional open orchiopexy remains the standard treatment for palpable undescended testicles (UDT). However, laparoscopic orchiopexy has recently gained attention as an alternative approach.

AIM AND OBJECTIVES

This study aimed to compare the outcomes of laparoscopic versus open orchiopexy for high-inguinal undescended testes.

SUBJECTS AND METHODS

A prospective randomized comparative study was conducted, involving 208 children with high inguinal undescended testes. The patients were divided into two groups: group A (104 patients) underwent laparoscopic orchiopexy and group B (104 patients) underwent open orchiopexy.

RESULTS

There was a significant difference in the final testicular position between the two groups. The follow-up after 1 year showed that 100% of patients in group A had a lower testicular position, compared to 72.6% in group B. Laparoscopic orchiopexy demonstrated better outcomes in terms of achieving a lower testicular position.

CONCLUSION

Both Laparoscopic and Open Orchiopexy are safe and effective for the treatment of high inguinal undescended testes. However, Laparoscopic Orchiopexy was superior to Open Orchiopexy because it was associated with better outcomes with regard to the final testicular position at the bottom of the scrotum or at a lower level below the mid-scrotal point.

摘要

背景

传统的开放式或经腹腔镜睾丸固定术仍然是可触及未降睾丸(UDT)的标准治疗方法。然而,经腹腔镜睾丸固定术最近作为一种替代方法受到关注。

目的和目标

本研究旨在比较腹腔镜与开放式睾丸固定术治疗高位腹股沟未降睾丸的结果。

受试者和方法

进行了一项前瞻性随机对照研究,涉及 208 例高位腹股沟未降睾丸患儿。将患者分为两组:A 组(104 例)行腹腔镜睾丸固定术,B 组(104 例)行开放式睾丸固定术。

结果

两组最终睾丸位置存在显著差异。1 年后的随访显示,A 组 100%的患者睾丸位置较低,而 B 组为 72.6%。腹腔镜睾丸固定术在实现较低睾丸位置方面具有更好的效果。

结论

腹腔镜和开放式睾丸固定术对于治疗高位腹股沟未降睾丸都是安全有效的。然而,腹腔镜睾丸固定术优于开放式睾丸固定术,因为它在最终睾丸位置(在阴囊底部或低于中阴囊点的更低位置)方面具有更好的结果。

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