腹腔镜下治疗非腹腔型隐睾的临床研究

Treatment of nonabdominal cryptorchidism under laparoscope: report of 47 cases

目的探讨腹腔镜在非腹腔型隐睾治疗中的临床意义。方法将我院2007年3月到2007年9月间收治的非腹腔型隐睾病人47例,随机分为开放手术组23例和腹腔镜手术组24例,分别行开放手术睾丸下降固定术和腹腔镜下睾丸下降固定术,通过分析手术结果、手术时间、住院时间,及各组术前及术后6个月的睾丸体积(V)、性激素水平(T、FSH、LH、E2)值的变化,来判断腔镜手术的疗效。结果47例均成功行一期睾丸下降固定术,腹腔镜手术组,术前、术后自身比较,术后6个月睾丸位置满意,睾丸体积无缩小(P>0.05)、T较术前升高(P<0.05)、FSH及E2较术前下降(P<0.05)、LH与术前无明显变化(P>0.05);腹腔镜手术组与开放手术组比较,手术时间无明显差异,住院时间缩短,两组术前及术后6月,V、T、FSH、E2、LH均无差别(P>0.05)。结论腹腔镜在非腹腔型隐睾的治疗中安全、有效,与传统开放手术疗效相同,可做为非腹腔型隐睾手术治疗的常规术式。

Objective To explore the clinical significance of nonabdominal cryptorchidism treatment under laparoscope. Methods Totally 47 patients of nonabdominal cryptorchidism at a mean age of 5.4 years old （ranging from 2 to 12） administrated in our hospital from March, 2007 to September, 2007 were divided into open-surgery group （23 cases） and laparoscopic surgery group （24 cases） randomly, and orchidopexy was carried out respectively. Operation time, length of stay and testicular volume, hormone level （T, FSH, LH, E2） of each patient before operation and 6 months after operation were measured to evaluate the efficacy. Results All 47 patients had orchidopexy carried out successfully. There was no significant difference of operation time between laparoscopic and open-surgery group, but the duration of hospitalization was decreased in the former group. Testicular position was satisfactory 6 months after operation in laparoscopic group, but the volume wasn’t decreased, while T level was increased, and those of FSH and E2 were decreased than that before operation （P0.05）. LH had no significant changes. Testicular volume, level of T, FSH, E2 and LH had no evident difference between laparoscopic and open-surgery group before and 6 months after operation. Conclusion It’s safe and effective to treat nonabdominal cryptorchidism under laparoscope, which may be adapted as routine treatment.