Seibold J, Janetschek G, Bartsch G
Department of Urology, University of Innsbruck, Austria.
Eur Urol. 1996;30(3):394-9. doi: 10.1159/000474202.
In pediatric urology laparoscopy is more and more used for diagnostic and therapeutic indications.
From January 1992 to August 1995, we performed 86 laparoscopic procedures in pediatric patients.
In 23 patients with cryptorchidism laparoscopy was used for diagnostic and/or therapeutic reasons. Laparoscopic repair of varicocele (n = 37) and hydrocele (n = 4) was performed. Vesicoureteral implantation was done in 6 patients and nephroureterectomy/heminephroureterectomy in 3 and 9 patients. In 2 patients vesical diverticulum were excised laparoscopically and in intersex laparoscopy was used in 2 patients.
Laparoscopy is the most reliable diagnostic tool in children with cryptorchidism and allows, if necessary, therapy in the same procedure, such as orchiectomy or dissection of the testicular vessels in preparation for a Fowler-Stephens procedure. For varicocele repair the laparoscopic approach offers a simple and effective method with a low recurrence rate. More technically demanding and performed only in specialized centers are laparoscopic nephrectomy or heminephroureterectomy. These latter procedures have shown to be superior to the open surgical approach regarding morbidity, complication rate and hospital stay.
在小儿泌尿外科中，腹腔镜越来越多地用于诊断和治疗指征。
1992年1月至1995年8月，我们对小儿患者进行了86例腹腔镜手术。
23例隐睾症患者因诊断和/或治疗原因接受了腹腔镜检查。进行了腹腔镜精索静脉曲张修复术（n = 37）和鞘膜积液修复术（n = 4）。6例患者进行了膀胱输尿管植入术，3例和9例患者分别进行了肾输尿管切除术/半肾输尿管切除术。2例患者通过腹腔镜切除膀胱憩室，2例两性畸形患者接受了腹腔镜检查。
腹腔镜检查是隐睾症患儿最可靠的诊断工具，如有必要，可在同一手术中进行治疗，如睾丸切除术或解剖睾丸血管以准备福勒-斯蒂芬斯手术。对于精索静脉曲张修复，腹腔镜手术提供了一种简单有效的方法，复发率低。腹腔镜肾切除术或半肾输尿管切除术技术要求更高，仅在专业中心进行。这些手术在发病率、并发症发生率和住院时间方面已显示出优于开放手术方法。
