腹腔镜在小儿性发育障碍诊疗中的应用

目的探讨腹腔镜在小儿性发育障碍的诊断及治疗中的应用。方法2010年2月至2012年6月我们收治32例尿道下裂合并隐睾患儿，均行腹腔镜性腺探查，其中有12例性发育障碍患儿，本文对该组12例患儿进行回顾性研究。结果本组患儿经腹腔镜性腺探查及活检，明确诊断后，切除与确定性别不符的性腺、内生殖管道（卵巢及输卵管）、尽量保留男性性腺。术后未见明显手术并发症，所有患儿均按男孩抚养，性腺切除术后6～9个月行尿道成形术。随访2～16个月，平均12．5个月，患儿保留之性腺与外生殖器发育基本正常，社会性别与生长发育基本协调。结论应用腹腔镜技术治疗性发育障碍患儿的诊断及治疗优势明显，该手术方式值得进一步实践。

Objective To investigate the value of laparoscopy in the diagnosis and treatment of Disorders of Sex Development (DSD) in children.Methods From February 2010 to June 2012,32 patients with hypospadias and cryptorchidism underwent evaluation and treatment by laparoscopy.Out of these,12 patients were diagnosed as DSD.The diagnosis and treatment of these patients were retrospectively analyzed.Results At evaluation,all patients underwent laparoscopic removal of gonads and/or ductal structures incompatible with the socially chosen gender.Urethroplasty was performed 6 ～ 9 months after laparoscopic gonadectomy.There were no intra-operative or postoperative complications.All patients recovered well during 2 to 16 month follow-up (mean 12.5 months) with good cosmetic outcomes.Conclusions Laparoscopy is a good approach for diagnosing and treating patients with DSD