Walc L, Bass J, Rubin S, Walton M
Department of Surgery, Children's Hospital of Eastern Ontario, University of Ottawa, Canada.
J Pediatr Surg. 1995 Aug;30(8):1195-7. doi: 10.1016/0022-3468(95)90020-9.
This study assessed testicular viability after 476 inguinal procedures performed in 338 infants under 6 months of age, between 1974 and 1993. One hundred twenty-one elective hernia repairs (contralateral explorations) were compared with 355 hernia repairs complicated by incarceration and/or orchiopexy. Clinical examination of 323 testes in the early postoperative period showed 20 atrophic testes. Since January 1994, 71 of the 338 patients have had testicular measurements obtained through ultrasonography (US). An additional 13 atrophic testes were found during US examination. Of these, nine were believed to be normal during early postoperative examination. Assuming that US examination will confirm atrophy in the 20 atrophic testes noted early in the postoperative clinical evaluation, and that all other testes not yet scanned are found to be normal, the minimal atrophy rate (MAR) would be 9.3% (33 of 355). Neither operative nor early postoperative testicular assessment correlates with ultimate testicular survival. Testicular pathology may become more evident after puberty, and the real incidence of atrophy may increase.
本研究评估了1974年至1993年间，对338名6个月以下婴儿实施的476例腹股沟手术术后的睾丸活力。将121例择期疝修补术（对侧探查）与355例并发嵌顿和/或睾丸固定术的疝修补术进行了比较。术后早期对323个睾丸进行的临床检查显示有20个睾丸萎缩。自1994年1月起，对338例患者中的71例进行了超声（US）睾丸测量。超声检查又发现了13个萎缩睾丸。其中，9个在术后早期检查时被认为是正常的。假设超声检查将证实术后临床评估早期发现的20个萎缩睾丸发生萎缩，且所有其他未扫描的睾丸均被发现正常，那么最小萎缩率（MAR）将为9.3%（355个中的33个）。手术时或术后早期的睾丸评估均与睾丸最终存活情况无关。睾丸病理改变在青春期后可能会更加明显，萎缩的实际发生率可能会增加。
