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男性假两性畸形的腹腔镜性腺切除术

Laparoscopic gonadectomy in male pseudohermaphrodites.

作者信息

Kriplani A, Abbi M, Ammini A C, Kriplani A K, Kucheria K, Takkar D

机构信息

Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi.

出版信息

Eur J Obstet Gynecol Reprod Biol. 1998 Oct;81(1):37-41. doi: 10.1016/s0301-2115(98)00143-2.

Abstract

OBJECTIVE

To study patients of male pseudohermaphroditism and establish the laparoscopic approach for gonadectomy in these cases.

STUDY DESIGN

Seven phenotypic females with XY karyotype were evaluated through a diagnostic protocol which included clinical, cytogenetic, hormonal, endoscopic and histologic evaluation. The gonads were then removed by laparoscopic surgery.

RESULTS

The seven patients included three patients of pure gonadal dysgenesis, two patients of testicular feminization and one patient each of mixed gonadal dysgenesis and dysgenetic male pseudohermaphroditism. Two of the seven patients (28.57%) had gonadal neoplasias on histopathology-one dysgerminoma and one occult seminoma. In all of these patients, removal of the gonads was accomplished laparoscopically. No complications occurred during any of the surgeries.

CONCLUSION

Due to the reduced morbidity, shorter hospital stay and safety, laparoscopic gonadectomy can be considered the treatment of choice for the removal of gonads in male pseudohermaphrodites in the hands of experienced laparoscopic surgeons.

摘要

目的

研究男性假两性畸形患者,并建立此类病例性腺切除术的腹腔镜手术方法。

研究设计

对7例核型为XY的表型女性患者进行了诊断评估,评估方案包括临床、细胞遗传学、激素、内镜及组织学评估。随后通过腹腔镜手术切除性腺。

结果

7例患者中,包括3例单纯性腺发育不全患者、2例睾丸女性化患者、1例混合性腺发育不全患者和1例发育异常的男性假两性畸形患者。7例患者中有2例(28.57%)组织病理学检查发现性腺肿瘤,1例无性细胞瘤,1例隐匿性精原细胞瘤。所有这些患者均通过腹腔镜完成性腺切除。所有手术均未发生并发症。

结论

由于发病率降低、住院时间缩短且安全性高,对于经验丰富的腹腔镜外科医生而言,腹腔镜性腺切除术可被视为男性假两性畸形患者性腺切除的首选治疗方法。

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