睾丸横过异位的诊治(附1例报告)

DIAGNOSIS AND TREATMENT OF TRANSVERSE TESTICULAR ECTOPIA WITH ONE CASE REPORT

目的探讨睾丸横过异位的腹腔镜诊治优势。方法患儿男性,1岁4月行术前超声提示右侧阴囊内睾丸缺如,左侧腹股沟管下段及左侧阴囊内均见睾丸回声,给予腹腔镜诊治。结果腹腔镜下见右侧睾丸精索血管横跨异位于左侧内环口处,左侧睾丸位于腹股沟管内,精索输精管起源于双侧相伴行,双侧内环口均未闭合,未发现苗勒氏管残留,术中诊断:左侧游离睾丸,右侧睾丸横过异位。腹腔镜下游离精索血管输精管,经双侧内环口分别将睾丸通过腹股沟管复位固定到两侧阴囊内肉膜间隙下。手术顺利,术后门诊随访3个月,患儿双侧睾丸血运良好,位置理想。结论睾丸横过异位是罕见睾丸下降不良畸形,宜及早诊治,腹腔镜治疗较成功且有优势。

Objective To explore the advantages of using laparoscopy to diagnose and treat transverse testicular ectopia（TTE）.Methods The boy aged 16 months underwent ultrasonography.Absence sign of testis wasfound in the right scrotum,and testicular echoes were found under the left inguinal canal and the left scrotum.Laparoscopy was used to diagnose and treat TTE.Results Under the laparoscope,spermatic vessels in the right testes stretched across the left internal inguinal ring.Both the vasa deferentia originated from the same left side and travelled in parallel.The left spermatic vessels was normally in the ipsilateral internal ring,and the right counterparts traversedalong peritoneal folds of the pelvic cavity into the contralateral internal ring.No presence of müllerian duct structures was found.After dissociating right spermatic cord by laproscopy,a transseptal orchiopexy was performed for the ectopic right testicle in open operation from left inguinal canla incision.The surgery was successful.The three-month follow-up surveys showed that both testes got good blood supply and were fixed in the right location.Conclusion TTE is an uncommon malformation of testicular descent and should be diagnosed and treated early.Laparoscopy has proved to have some advantages in diagnosing and treating TTE.