摘要
目的探讨腹腔镜在未触及睾丸隐睾患儿中的应用价值。方法选取2007年12月～2014年6月诊疗的未触及睾丸的隐睾患儿40例（45侧）,根据患儿情况在腹腔镜下行相应手术治疗。腹腔内睾丸33例（38侧）,其中行一期睾丸下降固定术29例（33侧）,分期睾丸下降固定术4例（5侧）;精索血管进入腹股沟管6例（6侧）,行腹股沟区探查术;1例（1侧）腹腔内见输精管呈盲端,镜下切除。结果 40例（45侧）均手术顺利。手术时间34～65 min,平均46 min。术后住院时间2～5 d,平均3.2 d。40例随访6～24个月,平均8.7月。睾丸回缩至阴囊上方4例,睾丸萎缩1例,阴囊水肿、血肿3例,无睾丸扭转坏死。结论腔镜技术暴露清楚,解剖明确,不易损伤周围组织,对患儿创伤较小,有助于提高睾丸下降固定的成功率,尤其对腹腔内盲端输精管和很高位置的睾丸有较好的治疗效果,对治疗小儿高位隐睾具有重要的临床价值。
Objective To investigate the application value of laparoscopy in the treatment of impalpable testis in children.Methods Clinical data of 40 children with impalpable testis（ 45 sides） from December 2007 to June 2014 were retrospectively analyzed. The sites and sizes of the testis were identified by abdominopelvic ultrasonography in all the patients. The findings and management included： 33 cases of intra-abdominal testis（ 38 sides） were treated with one-session（ 29 cases,33 sides） or two-staged（ 4 cases,5 sides） orchidopexy; 6 cases of cord structure entering the internal inguinal ring（ 6 sides） were treated with inguinal exploration; 1 case was given a vasectomy after laparoscope exploration indicating that cord structure was caecum（ 1 side）. Results All the 40 cases（ 45 sides） were successfully operated. The operative time was 34- 65 min（ mean,46 min） and the postoperative hospital stay was 2- 5 days（ mean,3. 2 days）. Forty cases were followed up for 6- 24 months（ mean,8. 7 months）. There were 4cases of testicular retraction to the top of the scrotum,1 case of atrophy of testis,and 3 cases of scrotal edema and hematoma. No testicular torsion and necrosis happened. Conclusions Laparoscopic surgery can obtain clear exposure and anatomy,less damage the surrounding tissue,and less trauma in children,which can improve the success rate of the fixed testicular descent,especially for intra-abdominal blind vas deferens and high position of testis. Laparoscopic surgery has an important clinical value for treating children with high cryptorchidism.
出处
《中国微创外科杂志》
CSCD
北大核心
2016年第4期382-384,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
隐睾
未触及
腹腔镜
Cryptorchidism
Impalpable
Laparoscopy
