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隐睾的处理。

Management of undescended testis.

机构信息

Department of Surgery, Children's Mercy Kansas City.

Department of Surgery, University of Missouri - Kansas City School of Medicine, Kansas City, Missouri, USA.

出版信息

Curr Opin Pediatr. 2024 Oct 1;36(5):554-561. doi: 10.1097/MOP.0000000000001387. Epub 2024 Jul 31.

Abstract

PURPOSE OF REVIEW

Describe why this review is timely and relevant.Undescended testis, or cryptorchidism, is a common diagnosis encountered by pediatricians that requires timely collaboration with pediatric surgical specialists to optimize outcomes for these patients. As this topic continues to be heavily researched, it is imperative to understand current recommendations and emerging management options including new surgical techniques, as well as common pitfalls in care highlighted in the literature.

RECENT FINDINGS

Describe the main themes in the literature covered by the article.This review primarily examines current practice in management including delays in surgical referral, with unnecessary imaging being a key factor that delays time to surgery. This review briefly discusses the diagnosis of undescended testis and the various surgical techniques used including the more recently proposed laparoscopic staged traction orchiopexy (Shehata technique). The ineffectiveness of hormonal therapy is also addressed.

SUMMARY

describe the implications of the findings for clinical practice or research.This review emphasizes prompt evaluation and diagnosis of undescended testis to facilitate appropriately timed surgical intervention, which plays a major role in outcomes for these patients. Identifying patients at risk of delayed referral is an area of focus for improvement, along with better resource utilization with fewer imaging. Familiarization of surgical options can also facilitate better patient education and provider understanding of risks/benefits.

摘要

目的综述

描述为什么本次综述具有及时性和相关性。隐睾,即睾丸未降,是儿科医生常见的诊断,需要与小儿外科专家及时合作,以优化这些患者的治疗效果。由于该主题仍在深入研究,因此必须了解当前的建议和新的管理选择,包括新的手术技术,以及文献中强调的常见护理误区。

最新发现

描述文章涵盖的文献中的主要主题。本次综述主要研究了包括手术转诊延迟在内的管理现状,其中不必要的影像学检查是导致手术时间延迟的关键因素。本文简要讨论了隐睾的诊断和各种手术技术,包括最近提出的腹腔镜分期牵引睾丸固定术(Shehata 技术)。还讨论了激素治疗无效的问题。

总结

描述研究结果对临床实践或研究的意义。本次综述强调了及时评估和诊断隐睾,以促进适时进行手术干预,这对患者的治疗效果至关重要。确定延迟转诊的风险患者是需要改进的重点领域,同时还需要更好地利用资源,减少影像学检查。熟悉手术选择还可以促进更好地对患者进行教育,并让提供者更好地了解风险/获益。

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