腹腔镜辅助下腹股沟手术治疗高位难治性医源性隐睾

Laparoscopic Assisted Inguinal Surgery for the Treatment of High Refractory Iatrogenic Cryptorchidism

【目的】探讨腹腔镜辅助下腹股沟手术治疗高位难治性隐睾的临床效果。【方法】回顾性分析2014年1月至2017年4月本院小儿泌尿外科收治的21例单侧高位难治性医源性隐睾患儿,均采用腹腔镜辅助下腹股沟切口治疗。术后随访3个月至1年,记录患儿患侧睾丸恢复情况、术后并发症及有无回缩现象。【结果】21例患儿均顺利完成手术,手术时间58~125（78.6±15.3）min,术后无阴囊血肿、腹痛等并发症,术后6 h进食,3~5 d出院。术后随访：体查及彩超复查显示睾丸均无萎缩,血流正常,其中9例较术前增大,但较健侧睾丸小,均固定于阴囊底部,无再次回缩现象。5例患儿腹股沟切口因再次手术有瘢痕形成,整形科予疤克外涂及激光处理后基本消退。【结论】高位难治性隐睾腹腔镜辅助下腹股沟手术治疗安全有效,可最大限度保证睾丸血运,安全有效。

【Objective】To investigate the clinical effect of laparoscopic assisted inguinal surgery in the treatment of high refractory cryptorchidism.【Methods】From January 2014 to April 2017, 21 children with unilateral high and refractory iatrogenic cryptorchidism were treated with laparoscopic assisted inguinal incision. The patients were followed up for 3 months to 1 year to record the recovery of the affected testis, postoperative complications and the phenomenon of retraction.【Results】All the 21 children underwent the operation successfully, and the operation time was 58～125 （78.6 ±15.3）min. No postoperative complications such as scrotal hematoma, abdominal pain, etc. The patients started eating at 6 hours after operation and was discharged from hospital 3～5 days later. The results of follow up showed that there was no atrophy of testis and normal blood flow in all of them, 9 of them were larger than those before operation, but smaller than those of normal side, all of them were fixed at the bottom of scrotum and had no retraction. There were 5 cases of inguinal incision scar formation due to re-operation. After applied scar and laser treatment of the plastic surgery department, the symptoms basically subsided.【Conclusion】Laparoscopically assisted inguinal surgery with high refractory cryptorchidism is safe and effective in the treatment of testicular blood flow.