腹腔镜下腹腔内高位隐睾下降固定术的疗效观察

Clinical Observation of Laparoscopy in the Management of Nonpalpable Undescended Testes

目的:探讨腹腔镜下腹腔内高位隐睾下降固定术的疗效。方法:应用腹腔镜技术进行诊断并行隐睾下降固定术治疗不可触及的高位腹腔内型隐睾患儿21例(24侧),年龄2～12岁,平均4岁。结果:21例患儿均得到明确诊断。14例(17侧)行一期睾丸下降固定术.3例行Fowler-Stephen一期睾丸下降固定术,3例睾丸缺如,1例行睾丸萎缩切除术。随访6～30个月,平均16个月,下降固定的睾丸位置良好,睾丸均无萎缩和回缩。结论:采用腹腔镜技术可以准确诊断高位不可触及的腹腔内型隐睾,并可同时行睾丸下降同定术,安全、有效、微创,值得推广。

Objective： To evaluate the effect of laparoscopy in the management of nonpalpable undescended testes. Methods：We evaluated the results and advantages of laparoscopic examination in 21 children with 24 nonpalpable testes, age from 2 years old to 12 years old, the average was 4 years old. Results：21 cases were diagnosed definitely. One.stage standand orchiopexy was performed in 14 children （17 sides）, 3 children underwent one-stage Fowler Stephens procedure. Atrophic testicle was found in 1 child, who underwent an orchiectomy. The testicle was absent in 3 children. Postoperative follow-up for 6 30 months （mean 16 months） showed that all managed testis were in a normal scrotal position. None of them had retraction or atrophy of the testis. Conclusions： Laparoscopic evaluation in children with nonpalpahle testes gives us precise information as to the existence and location of the testicle which is helpful in determining subsequent appropriate procedure and avoiding unnecessary abdominal exploration. The utilization of laparoscopy is less invasive method and appears to be the gold standard.