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睾丸扭转的治疗:土耳其小儿外科医生和小儿泌尿科医生的调查。

The management of testicular torsion: A survey of Turkish pediatric surgeons and pediatric urologists.

机构信息

Department of Pediatric Surgery, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul-Türkiye.

出版信息

Ulus Travma Acil Cerrahi Derg. 2024 Sep;30(9):685-693. doi: 10.14744/tjtes.2024.52932.

DOI:10.14744/tjtes.2024.52932
PMID:39222498
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11622717/
Abstract

BACKGROUND

This study aimed to evaluate the approaches of pediatric surgeons and pediatric urologists in Türkiye regarding the diagnosis and treatment of testicular torsion (TT) and their adherence to the European Association of Urology (EAU) pediatric urology guideline.

METHODS

A survey consisting of 19 questions, accompanied by an annotation describing the objective of the study, was emailed to pediatric surgeons and pediatric urologists in June and July 2023.

RESULTS

Of the 95 respondents, 62.1% had over 10 years of experience, and 48.4% treated more than five cases of TT annually. Of the participants, 87.4% stated that scrotal Doppler ultrasonography (US) was always used, and 12.6% stated that US was used in cases of doubtful diagnosis. Concerning treatment, 14.7% reported performing manual detorsion, 70.5% never did, and 14.7% did so only if the operating room was unavailable soon. A total of 92.6% of participants opted for emergency surgery. Among participants who perform manual detorsion, 71.4% perform surgery within 24 hours after successful manual detorsion. Regarding fixation of the contralateral testicle, 14.7% never performed it, and 27.4% did so only when they performed an orchiectomy on the torsion testicle.

CONCLUSION

While most participants follow EAU pediatric urology guidelines by performing emergency surgery, the rate of manual detorsion is low. Few participants stated that emergency surgery may not be performed after manual detorsion. While all of the participants performed fixation of the torsion testicle in accordance with the guidelines, the same adherence was not observed in the contralateral testicle.

摘要

背景

本研究旨在评估土耳其儿外科医生和小儿泌尿科医生在诊断和治疗睾丸扭转(TT)方面的方法,以及他们对欧洲泌尿外科学会(EAU)小儿泌尿科指南的遵循情况。

方法

2023 年 6 月至 7 月,向儿外科医生和小儿泌尿科医生发送了一份包含 19 个问题的调查,附有一份说明研究目的的注释。

结果

在 95 名受访者中,62.1%的人有超过 10 年的经验,48.4%的人每年治疗超过 5 例 TT。87.4%的参与者表示始终使用阴囊多普勒超声(US),12.6%的人表示在怀疑诊断时使用 US。在治疗方面,14.7%的人报告进行手动复位,70.5%的人从不进行,14.7%的人仅在手术室很快无法使用时进行。92.6%的参与者选择急诊手术。在进行手动复位的参与者中,71.4%的人在手动复位成功后 24 小时内进行手术。关于对对侧睾丸的固定,14.7%的人从不进行,27.4%的人仅在对扭转睾丸进行睾丸切除术时进行。

结论

虽然大多数参与者通过进行急诊手术来遵循 EAU 小儿泌尿科指南,但手动复位的比例较低。少数参与者表示手动复位后可能不会进行急诊手术。虽然所有参与者都按照指南对扭转的睾丸进行固定,但对侧睾丸则没有同样的遵循。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f33/11622717/4da1e3cd1b13/TJTES-30-685-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f33/11622717/4da1e3cd1b13/TJTES-30-685-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f33/11622717/4da1e3cd1b13/TJTES-30-685-g001.jpg

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J Pediatr Urol. 2023 Feb;19(1):117-124. doi: 10.1016/j.jpurol.2022.09.020. Epub 2022 Sep 24.
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A BURST-BAUS consensus document for best practice in the conduct of scrotal exploration for suspected testicular torsion: the Finding consensus for orchIdopeXy In Torsion (FIX-IT) study.一份关于疑似睾丸扭转进行阴囊探查的最佳实践的BURST-BAUS共识文件:睾丸扭转固定术中寻找共识(FIX-IT)研究。
BJU Int. 2022 Jun 10;130(5):662-70. doi: 10.1111/bju.15818.
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