微型腹腔镜在未触及型小儿隐睾诊治中的应用

Application of mini-laparoscopy in the diagnosis and management of nonpalpable undescended testis in children

目的 探讨腹腔镜在未触及睾丸的隐睾诊治中的作用.方法 对38例未触及睾丸的隐睾患儿行腹腔镜探查（46个睾丸）及手术.结果 经腹腔镜、腹股沟探查及术后病理证实睾丸缺如2个,腹股沟型高位隐睾34个,睾丸位于腹腔内10个.除睾丸缺如者外,行微型腹腔镜辅助一期睾丸下降固定术41个睾丸,Fowler-Stephens （F-S）分期睾丸固定术3个睾丸；术后随访患侧睾丸萎缩2个,包括行腹腔镜下期睾丸固定术1个睾丸,F-S分期固定术1个睾丸；睾丸回缩1个,为腹腔镜下一期睾丸下降固定术者.结论 对于腹股沟未能查到睾丸的小儿隐睾症应行腹腔镜检查,该方法定位准确,且多数患儿能行一期下降固定,腹腔内较高位者需分期手术,总体治疗效果满意.

Objective To explore the application of mini-laparoscopy in the diagnosis and management of nonpalpable undescended testis in children. Methods 38 cases of impalpabal testes（46 testicular） had been opera- ted by mini-laparoscopy in children with cryptorchidism. Results 38 children with nonpalpable undescended testis （46 testicular） had been operated by mini-laparoscope. Results After laparoscopic exploration, inguinal probe and postoperative pathology,it had been confirmed that 2 testicular were absent,34 testicular were found in high inguinal location, 10 testicular were located in intraperitoneal cavity. In addition to the absent testicular,the rest had been per- formed with mini-laparoscope： one period descent fixation 41 testes, Fowler-Stephens （F-S） installment orchiopexy three testes. Follow-up with side testicular atrophy 2,including one period orchi0pexy a testis, F-S installment fixation a testicular;Testicular rebound 1, who had been operated with one phase of testicular descent fixtion. Conclusion For inguinal failed to find the testicular, children with cryptorchidism should be done by laparoscopy because of its po- sitioning accuracy, and most children can do a period drop fixed, but for those really intraperitoneal more exalted per- son, stage surgery should be needed. Its overall treatment effect is satisfactory and is worth popularizing.