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睾丸肿物都需要进行睾丸切除术吗?

Does testicular mass always require orchiectomy?

作者信息

Godec C J, Fencl R J, Cass A S, Fisher R D

出版信息

Urology. 1982 Mar;19(3):263-8. doi: 10.1016/0090-4295(82)90496-4.

Abstract

Surgical exploration of a testicular mass should follow the basic principles of cancer surgery, including an inguinal approach, occlusion of the spermatic vessels, opening of the tunica vaginalis, and careful exploration of the testicle, epididymis, paratesticular structures, and spermatic cord. In a very few patients, when intratesticular lesion is small and moveable and can be seen through the tunica albuginea, and if there is a long history of scrotal mass, then the tunica albuginea should be opened and intratesticular exploration performed. The opening of the tunica albuginea should be opened and intratesticular exploration performed. The opening of the tunica albuginea does not violate the principles of cancer surgery, and for a few selected cases can prevent unnecessary orchiectomy. The incision of the tunica albuginea should no longer represent a surgical taboo to the urologist. Six cases of rare, benign intratesticular tumors are presented along with a rare indication for intratesticular exploration and testicle-preserving surgery.

摘要

对睾丸肿块进行手术探查应遵循癌症手术的基本原则,包括采用腹股沟入路、阻断精索血管、打开鞘膜、仔细探查睾丸、附睾、睾丸旁结构及精索。在极少数患者中,当睾丸内病变较小且可移动,能透过白膜看到,并且阴囊肿块病史较长时,应打开白膜并进行睾丸内探查。打开白膜进行睾丸内探查并不违反癌症手术原则,对于少数特定病例可避免不必要的睾丸切除术。对白膜进行切开不应再成为泌尿外科医生的手术禁忌。本文介绍了6例罕见的良性睾丸内肿瘤病例,以及睾丸内探查和保留睾丸手术的罕见指征。

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