Vaysse P
Département de Chirurgie Pédiatrique, Centre Hôpitalo-Universitaire, Toulouse Purpan.
Eur J Pediatr Surg. 1994 Dec;4(6):329-32. doi: 10.1055/s-2008-1066127.
The value of laparoscopy in managing the impalpable testis remains controversial. Several reports have been published on this topic but series are usually short and rather heterogeneous in their presentation, so that critical analysis is not easy to perform. Therefore, the Groupe d'Etude en Coeliochirurgie Infantile started a multicentric prospective study in May 1991 with two objectives: what are the laparoscopic findings and what are the correlations between laparoscopy and surgery? In addition, this study tried to estimate the therapeutic implications. Two hundred and one boys underwent laparoscopy accounting for two hundred and thirty-two impalpable testis. Laparoscopic findings were mainly of three types: intra-abdominal testis (36%), abdominal blind ending cord structures (14%) and cord structures entering the deep inguinal ring (49%); rarely, there was absence of testis and cord structures (1%). Crossed testicular ectopia was not found in this series. One hundred and eighty-seven impalpable testis were operated on to control laparoscopic findings and correlations laparoscopy-surgery were excellent provided that laparoscopic exploration could be entirely performed in good conditions. Moreover, it could be evaluated that forty-seven per cent of impalpable testes could take advantage of laparoscopy.
腹腔镜检查在处理隐睾方面的价值仍存在争议。关于这一主题已发表了多篇报告，但病例系列通常较短且呈现方式相当不一致，因此难以进行批判性分析。因此，小儿腔镜外科学研究小组于1991年5月启动了一项多中心前瞻性研究，目标有两个：腹腔镜检查的结果是什么，以及腹腔镜检查与手术之间的相关性如何？此外，该研究试图评估其治疗意义。201名男孩接受了腹腔镜检查，共计232个隐睾。腹腔镜检查结果主要有三种类型：腹腔内睾丸（36%）、腹部盲端精索结构（14%）和进入腹股沟深环的精索结构（49%）；很少见的是，睾丸和精索结构缺如（1%）。本系列未发现交叉睾丸异位。为了验证腹腔镜检查结果，对187个隐睾进行了手术，只要腹腔镜探查能在良好条件下完整进行，腹腔镜检查与手术之间的相关性就非常好。此外，可以评估出47%的隐睾可受益于腹腔镜检查。
