摘要
目的探讨不同位置的隐睾,采用不同微创手术方式的效果及可行性。方法自2013年6月至2016年6月我院收治各类隐睾共56例。腹腔型隐睾9例采用腹腔镜手术。腹腔镜下游离患侧睾丸及精索,自腹股沟管将睾丸牵入阴囊,固定于阴囊底部肉膜囊内。阴囊高位型隐睾及滑动睾丸6例采用单纯经阴囊切口手术(Bianchi),直接于患侧阴囊底部皮肤皱褶内做顺皮纹切口,游离精索,将睾丸固定于肉膜囊内。腹股沟型隐睾41例,采用腹腔镜手术与Bianchi手术相结合的治疗方法,不将睾丸提入腹腔,不切断睾丸引带,腹腔内游离精索后,将睾丸下推至阴囊,然后转至阴囊部操作,采用Bianchi手术,将睾丸固定于阴囊底部肉膜囊内。结果全部病例均顺利完成手术,达到睾丸无张力固定于阴囊底部的效果。平均手术时间,腹腔型(65±8)min,腹股沟型(56±6)min,阴囊型(45±5)min。术后恢复顺利,无围手术期并发症出现。术后第3天出院。随访3~12个月,所有病例睾丸位置均位于阴囊底部,无睾丸萎缩或回缩病例,血供良好,发育正常。结论根据睾丸位置选取不同的微创手术方式,使隐睾手术全部达到微创化治疗,损伤小,恢复快,无明显切口瘢痕,精索游离充分,能够将睾丸固定于阴囊低位,效果满意。
Objective To evaluate the clinical efficacy and feasibility of different minimally invasive surgical approaches in treating cryptorchidism in different positions. Methods Fifty-six patients diagnosed with cryptorchidism were admitted to our hospital between June 2013 and June 2016. Nine cases of abdominal cryptorchidism underwent laparoscopic surgery. Under laparoscope, the affected testis and spermatic cord were separated free, the testis was pulled into the scrotum through the inguinal canal and fixed in the dartos pouch at the scrotal bottom. Six patients with high cryptorchidism and gliding testis underwent single scrotal incision surgery （Bianchi）. Dermotoglyphic incisions were made at the bottom of the affected scrotum, spermatic cord was separated free and the testis was fixed within the dartos pouch. Forty-one patients with inguinal cryptorchidism underwent laparoscopic combined with Bianchi surgeries. The testis was not pulled into the abdominal cavity and the gubernaculum testis was not cut off. After the separation of spermatic cord, the testis was pulled into the scrotum, and fixed in the dartos pouch at the scrotum bottom using Bianchi technique. Results All patients successfully underwent the surgery. The testes were fixed at the bottom of scrotum without tension. The mean operation time was （65±8） min for patients with abdominal cryptorchidism, （56±6） min for those with inguinal cryptorchidism and （45±5） min for those with scrotal cryptorchidism. All cases were successfully recovered and discharged on the third day after surgery. No complications occurred during peroperative period. The follow-up endured for 3 to 12 months. The testes were located at the scrotal bottom in all cases. No testicular atrophy or retraction was noted. Excellent blood supply and normal development were observed. Conclusion Different minimally invasive surgeries should be chosen according to the position of testis. Minimally invasive surgery of cryptorchidism is performed, which leads to mild injury with
作者
张友波
张敏
杜智军
陈建勋
管肖浩
姚瑶
崔源
Zhang Youbo Zhang Min Du Zhijun Chen Jianxun Guan Xiaohao Yao Yao Cui Yuan.(Department of Dediatric Surgery, Nantong Maternal and Child Health Hospital, Jiangsu 226018, China)
出处
《中华腔镜泌尿外科杂志（电子版）》
2017年第3期27-30,共4页
Chinese Journal of Endourology(Electronic Edition)
关键词
小儿
隐睾
睾丸下降固定术
微创
Children, cryptorchidism
Orchidopexy
Minimally invasive
