保留睾丸手术治疗良性睾丸肿瘤的临床应用

Testis-sparing surgery for benign testicular tumor

目的：探讨保留睾丸手术治疗成人睾丸肿瘤的安全性和可行性。方法：分析我院2005年10月至2012年3月间手术治疗的8例睾丸肿瘤患者的临床资料。结果：8例患者年龄18-67岁,平均年龄45岁,术前检查后,考虑为良性病变。8例患者成功实施睾丸部分切除术,术中均行快速病理确认手术切缘阴性。术后经病理检查和免疫组化诊断睾丸支持细胞瘤3例,腺瘤样瘤3例,成熟畸胎瘤2例。8例患者随访6个月-7年,平均4年,均未出现复发及转移;患者手术前后的睾酮水平、IIEF评分、精液常规指标无明显差异。结论：保留睾丸的睾丸部分切除术是治疗睾丸良性肿瘤的有效方法之一。对合适的患者,应仅最大限度保留睾丸组织,不影响患者术后的生活质量。

Objective： To investigate the safety and feasibility of testis-sparing surgery（ TSS） in the treatment of testicular tumor. Methods： We retrospectively analyzed the clinical data of 8 cases of benign testicular tumor treated by TSS in our hospital from October 2005 to March 2012. Results： The 8 patients,aged 18- 67（ mean 45） years,were preoperatively diagnosed with benign testicular tumor and all underwent partial testis resection. Rapid intraoperative pathology showed the incisal margins to be negative. Postoperative pathological examination confirmed Sertoli cell tumor in 3 cases,adenomatoid tumor in another 3,and mature teratoma in the other 2. The patients were followed up for 6 months to 7 years（ mean 4 years）,which revealed no relapse and metastasis,nor significant differences from the baseline in the testosterone level,IIEF score,and routine semen parameters. Conclusion： Testissparing surgery is one of the effective options for the management of benign testicular tumor,which can maximally preserve the testis tissue and protect the patient＇s sexual function.