经脐入路腹腔镜下高位隐睾工期下降固定26例

Transumbilical laparoscpic one-stage orchiopexy for high cryptorchidism： report of 26 cases

目的 探讨经脐入路腹腔镜下对高位隐睾的Ⅰ期下降固定的方法 和疗效.方法 2008年12月至2009年7月收治26例（35侧）高位隐睾患儿,年龄1.1～6.3岁,平均1.9岁,其中左隐睾12例,右隐睾5例,双侧隐睾9例,单纯经肚脐入路行腹腔镜下睾丸探查和Ⅰ期下降固定.结果 探查发现6侧睾丸缺如,余29侧均在腹腔镜下行Ⅰ期睾丸下降周定,其中22例游离精索血管和输精管后将睾丸Ⅰ期下降固定,其余7侧睾丸行Ⅰ期Fowler-Stephens手术.术后随访6～13个月,平均9.6个月,下降的全部睾丸无回缩、无萎缩;脐部瘢痕隐藏于脐窝内不显露.结论 高位隐睾采用单纯经肚脐入路的腹腔镜技术,完成Ⅰ期下降固定是可行的,既能达到满意的治疗效果也能符合无瘢痕的美容要求.

Abstract：Objective To review the clinical outcomes of the trans-umbilical laparoscopic one stage orchiopexy for high cryptorchidism. Methods Twenty-six patients with the 35 sides high cryptorchidism （HC） including 12 left side, 5 right side, and 9 bilateral sides HC underwent transumbilical laparoscopic one stage orchiopexy. These patients ageed from 1.1 to 6. 3 years old with a mean age of 1.9 years. Results Twenty nine undescendent intra abdominal testes were found. Among them, 22were performed primary orchidopexy, and the other 7 were performed one stage Fowler-Stephens orchidopexy. Unilateral absent testis were noted in 6 patients. All patients were followed up for 6～13months （average 9. 6 months）. No testicular retraction or atrophy was noted. The scars were not revealable within the belly button during follow-up term. Conclusions Trans-umbilical laparoscopic exploration and orchidopexy is a nice choice for the diagnosis and treatment of the high cryptorchidism.