腹腔镜下未触及睾丸隐睾的诊治体会

Laparoscopy for the Diagnosis and Treatment of Cryptorchdism with Non-Palpable Testis

目的总结腹腔镜下未触及睾丸的隐睾的诊治经验并结合相关文献进行分析。方法对76例(85枚)未触及睾丸的隐睾患儿在腹腔镜下根据术中观察到的和游离的情况,分别采取相应的手术方式。结果76例(85枚)手术均顺利完成,其中睾丸缺如15枚(17.6%),没有进一步手术;精索血管进入腹股沟管49枚(57.7%),行腹股沟区探查;腹腔内睾丸21枚(24.7%)分别行一、二期睾丸下降固定术,术后无明显并发症。结论腹腔镜在小儿未触及睾丸的隐睾手术治疗中,具有定位准确、协助手术方便、手术损伤小等特点,是术后最大限度地保护未触及睾丸患儿生育能力的理想选择。

Objective To report the role of laparoscopy in the diagnosis and management of nonpalpable testis and analysize with related data. Methods 76 patients （85 sides） aging from 10month--10years underwent laparoscopy for nonpalpable testis. Results The findings and management included： 1. Absence of testis （15 sides, 17.6 %）, blind-ending or hypoplastic spermatic vessels and vas deferens were observed; 2. Cord structure entering the internal inguinal ring（49 sides, 57.7 %）, an inguinal exploration was needed ; 3. Intra-abdominal testis （21 sides, 24.7 %）, orchidopexy or orchidopexy in one or two stages was indicated. NO serious complications occurred. Conclusion Laparoscopy for the impalpable testis has proved to be a reliable means confirming the diagnosis of impalpable testis before operation and the virtue of minimal trauma and fast recovery. It also can help surgeon to make sure presence or absence and position of testes, and to plan the method of operation and accomplish operation. Laparoscopy exploration is the best choice of treatment in pretecting the fertilities of patients with the impalpable testis.