Falandry L
Service d'Urologie, Centre Hospitalier Universitaire de Niamey, Niger.
Prog Urol. 1995 Feb;5(1):69-73.
The author describes a new, simple technique for the treatment of idiopathic hydrocele according to a "fenestration" procedure designed to correct the imbalance of intravaginal hydrostatic exchanges. The operation consists of initially hemming separately the deep fibrous layer and the parietal leaflet of the tunica vaginalis to form the margins of the "window", which is then applied by its fibrous layer to the dartos, continuous with the subcutaneous connective tissue, a site of rich lymphatic drainage. In a series of 108 patients treated by this technique since September 1982, with a follow-up of 6 years, the anatomical and functional results were excellent in 98 cases (90.7%), moderate in 6 cases (5.5%) and poor in 4 cases (3.7%). Compared to classical techniques, the fenestrated opening of the tunica vaginalis with preservation of the tunica vaginalis and limited opening of the serosa, preserves the testicular support and the protective role of the serosa on the testis. Lastly, suture of the margins of the window to the dartos, by facilitating deep lymphatic drainage towards the superficial connective tissue, reconstitutes a physiological equilibrium in the constant exchanges of intravaginal serous fluids. Experience has demonstrated the anatomical and functional efficacy and reliability of this extremely simple procedure, which is essentially indicated in adult patients with idiopathic hydrocele and a healthy tunica vaginalis.
作者描述了一种新的、简单的治疗特发性鞘膜积液的技术，该技术依据一种“开窗” procedure（此处原文“procedure”未明确中文释义，可保留英文）设计，旨在纠正鞘膜内静水压交换的失衡。手术首先分别将深层纤维层和鞘膜壁层折边，以形成“窗口”的边缘，然后将其纤维层贴合于肉膜，肉膜与皮下结缔组织相连，是淋巴引流丰富的部位。自1982年9月以来，采用该技术治疗了108例患者，随访6年，解剖和功能结果优者98例（90.7%），良者6例（5.5%），差者4例（3.7%）。与传统技术相比，鞘膜开窗保留了鞘膜，浆膜开口有限，保留了睾丸的支撑结构以及浆膜对睾丸的保护作用。最后，将窗口边缘缝合至肉膜，通过促进深层淋巴液向浅表结缔组织引流，在鞘膜内浆液的持续交换中重建生理平衡。经验表明，这种极其简单的手术在解剖和功能方面具有有效性和可靠性，主要适用于患有特发性鞘膜积液且鞘膜健康的成年患者。
