Umeda Satoshi, Usui Noriaki, Nagata Kouji, Okuyama Hiroomi, Sato Yoshiaki, Maruyama Hidehiko, Masumoto Kouji, Yazaki Yuta, Okazaki Tadaharu, Kawaguchi Yunosuke, Toyoshima Katsuaki, Yamoto Masaya, Kim Kiyokazu, Inamura Noboru, Koike Yuhki, Yokoi Akiko, Terui Keita
Department of Pediatric Surgery, Osaka Women's and Children's Hospital, Izumi, Japan.
Department of Pediatric Surgery, Osaka Women's and Children's Hospital, Izumi, Japan.
J Pediatr Surg. 2025 Jun;60(6):162297. doi: 10.1016/j.jpedsurg.2025.162297. Epub 2025 Mar 27.
This study aimed to examine the incidence of undescended testis (UDT) in congenital diaphragmatic hernia (CDH) and clinical risk factors for developing UDT.
Male patients with CDH born between 2006 and 2021 were retrospectively assessed for UDT using the database of the Japanese CDH study group. The UDT risk factors were examined by comparing patients with and without UDT.
Of the 605 boys with CDH, 408 were followed for at least one year and were included in this study. A total of 50 (12.3 %) of the 408 patients experienced UDT and orchidopexy was performed in 41 (10.2 %) patients. Twenty-four cases developed UDT on the same side of CDH, whereas only 6 cases developed UDT on the contralateral side of CDH; the remaining 20 cases were bilateral UDT. Comparison between the patients with and without UDT revealed significantly lower birth weight and lower Apgar Score in the patients with UDT. Furthermore, patients with UDT demonstrated a significantly higher rate of non-isolated, "liver-up", defect with C/D type, and patch closure. Multivariate analysis showed that the C/D type defect was deemed an independent risk factor for developing UDT.
The incidence of UDT and the need for orchidopexy are elevated in boys with CDH. In patients with CDH, UDT may tend to occur on the same side as that affected by CDH. The diaphragmatic large defect was considered to be an independent risk factor for UDT in CDH although different factors are thought to be involved in testicular descent.
本研究旨在调查先天性膈疝（CDH）中隐睾（UDT）的发生率以及发生UDT的临床风险因素。
使用日本CDH研究组的数据库，对2006年至2021年出生的患有CDH的男性患者进行回顾性评估，以确定是否存在UDT。通过比较有UDT和无UDT的患者来检查UDT的风险因素。
在605例患有CDH的男孩中，408例至少随访了一年并纳入本研究。408例患者中共有50例（12.3%）发生UDT，41例（10.2%）患者进行了睾丸固定术。24例在CDH同侧发生UDT，而只有6例在CDH对侧发生UDT；其余20例为双侧UDT。有UDT和无UDT的患者比较显示，有UDT的患者出生体重和阿氏评分明显更低。此外，有UDT的患者非孤立性、“肝脏上移”、C/D型缺损及补片修补的发生率明显更高。多因素分析显示，C/D型缺损被认为是发生UDT的独立危险因素。
患有CDH的男孩中UDT的发生率及睾丸固定术的需求增加。在CDH患者中，UDT可能倾向于发生在与CDH同侧。尽管认为睾丸下降涉及不同因素，但膈大缺损被认为是CDH中UDT的独立危险因素。
