经阴囊单切口睾丸下降固定术治疗低位隐睾的临床研究

Single scrotal incision orchiopexies for low cryptorchidism

目的比较经阴囊上缘或中部单切口与经腹股沟阴囊双切口睾丸下降固定术治疗低位隐睾的临床效果。方法回顾性分析2013年3月至2014年4月复旦大学附属儿科医院收治的109例低位隐睾患儿的临床资料，分别经阴囊上缘单切口（A 组）、经阴囊中部单切口（B 组）和经腹股沟阴囊双切口（C 组）行睾丸下降固定术。比较三组手术时间、手术成功率及并发症的发生情况。结果109例患儿136侧手术均成功完成。A 组49例62侧，B 组23例33侧，C 组37例41侧。平均手术时间：A 组（38．14±12．80）min，B 组（37．48±11．07）min，差异无统计学意义（P ＞0．05），但 A、B 两组均较C 组[（44．38±13．37）min]短（P ＜0．05）。随访2-15个月，3组患儿术后均未出现严重并发症。结论3种手术切口均可安全有效地治疗低位隐睾，经阴囊上缘或中部单切口行睾丸下降固定术具有手术时间短、创伤小的优势，特别是经阴囊上缘单切口更为隐蔽美观。

Objetive To evaluate the single-scrotal incision orchiopexy for patients with low cryptorchid-ism.Methods A total of 136 orchiopexies were performed in 109 patients with a primary undescended testis during March 2013 to April 2014 in our hospital.Single prescrotal incision orchiopexy （group A）were per-formed in 49 patients,Single transscrotal incision orchiopexy （group B）in 23 patients and the traditional in-guinal orchiopexy （group C）in 37 patients. Results The operative time for group A and group B were （38.14 ±12.80）min and （37.48 ±11.07）min （P 〉0.05）,but the two groups both required shorter opera-tive duration than group C[（44.38 ±13.37）min]（P 〈0.05 ）.Follow-up ranged from 2 to 15 months,no wound infection, hernia, hydrocele, atrophyand retraction of testis were observed in all patients. Conclusion The prescrotal approach and the transscrotal approach both are safe and effective for low cryp-torchidism.And they have the advantages of shorter operative duration,simple procedure,fewer traumas,and excellently cosmetic result in comparison with the traditional inguinal approach.