经腹股沟皮纹横切口治疗小儿隐睾

Surgical operation of cryptorchidism in children by transverse incision of inguina dermatoglyph

目的探讨微创技术在小儿隐睾手术中的应用。方法根据小儿隐睾的临床特点,设计一种新的微创手术方式,即经腹股沟皮纹横切口治疗小儿隐睾,腹股沟皮纹横切口长2.0￣3.0cm,剪开浅深筋膜,部分切开腹股沟管前壁,提出睾丸及精索,分离鞘突管至腹膜外脂肪后结扎鞘状突,将睾丸下降固定于阴囊肉膜囊内。共治疗41例(53侧),术后随访6个月至2年;并与同期经传统腹股沟大斜切口手术的55例(61侧)进行对比。结果41例(53侧)出院时睾丸均位于阴囊内,术后获随访32例(39侧),其中11例(13侧)术前高位隐睾患儿术后睾丸位于阴囊中部,其余睾丸位于阴囊底部,未发现睾丸萎缩;与同期传统腹股沟大斜切口手术治疗的55例隐睾疗效相当,创伤小,恢复快。结论采用经腹股沟皮纹横切口治疗小儿隐睾创伤小,手术快,术后切口瘢痕不明显,外形美观,疗效满意,可替代传统腹股沟大斜切口手术治疗小儿隐睾。

Objective To explore the application of minimally invasive surgery in children＇s eryptorehidism Methods According to clinical features of eryptorehidism,was a new surgical procedure was A 2 - 3 cm transverse incision of inguina dermatoglyph was carried,then, cut the deep-superficial fascia to reveal anterior wall of inguinal canal and cut a segment, search for testicle and spermatie cord, dissect vaginal process to inner ring part of inguinal canal and ligate it, and then make orehiopexy in dartos muscle of serotum.A total of 41 children （53 testes ）with the cryptorehidism underwent the newly designed procedure and were followed up 6 24 months.in order to compare the curative effect of new surgical procedure,55 eases （61 testes） of eryptorehidism wnderwent traditional surgical teehnigue were used as compared patients. Results All the patients were discharged with satisfactory testieular position in the scrotum.Follow-up showed the testes located in scrotum.The 11 eases, （ 13 testes ） testes of them which were eryptorehidism of inner ring part of inguinal canal before operation located in the middle-part scrotum and the result located in the bottom -part scrotum,not testicular atrophy.There was no statistically significant between two surgical procedure to treat the curative effect of children＇ s eryptorehidism.The surgical outcomes were not different with that of those patients who undenvent trditional surgical operation. Conclusions The newly designed surgical procedure of minute transverse incision of inguina dermatoglyph is of micro-wound, shorter operation -time, minute scar of incision ,beautiful outlook of skin after operation, and satisfactory curative effect.It may replace traditionary surgical technique and well worthy to be introduced into clinical practice.