Lais A, Ferro F
Department of Pediatric Surgery, Bambino Gesù Children's Hospital, Rome, Italy.
Eur Urol. 1996;29(2):235-8; discussion 238-9.
Surgery of the inguinal canal is the most common practice in pediatric urology. Recently, the trans-scrotal approach has been described for orchidopexy of palpable undescended tests. The aim of this paper is to report our experience with this technique, emphasizing both the advantages and the disadvantages with respect to the usual approach.
Over a period of 2 years, we used the trans-scrotal approach in 85 children with cryptorchidism, hydrocele and inguinal hernia. The scrotal incision was combined vertical and horizontal.
All children with hernia and hydrocele were cured without complications. Among the cryptorchids, 3 children required an additional groin incision to complete the procedure, 3 experienced postoperative hematoma, 2 had mild testicular hypotrophy, and 1 recurrent cryptorchidism at follow-up.
Most palpable undescended testes can be successfully treated by this operation. However, the dissection of the processus vaginalis from the cord below the external ring is time-consuming, requires more skill, and exposes to more complications. Conversely, the results are excellent in hydroceles.
腹股沟管手术是小儿泌尿外科最常见的手术操作。最近，经阴囊途径已被描述用于可触及的隐睾的睾丸固定术。本文的目的是报告我们使用该技术的经验，强调相对于常规方法的优缺点。
在2年的时间里，我们对85例患有隐睾、鞘膜积液和腹股沟疝的儿童采用了经阴囊途径。阴囊切口采用垂直和水平相结合的方式。
所有患有疝和鞘膜积液的儿童均治愈，无并发症。在隐睾患儿中，3例需要额外的腹股沟切口来完成手术，3例术后出现血肿，2例有轻度睾丸萎缩，1例在随访时复发隐睾。
大多数可触及的隐睾可通过该手术成功治疗。然而，从外环下方的精索分离鞘突耗时，需要更多技巧，且会面临更多并发症。相反，鞘膜积液的手术效果极佳。
