腹腔镜联合阴囊小切口治疗低位隐睾的疗效观察

Curative Effect of Laparoscopy Combined with Scrotal Small Incision in Treatment of Low Cryptorchidism

目的:探讨应用腹腔镜联合阴囊小切口治疗低位隐睾的疗效。方法:回顾性分析31例(39侧)低位隐睾患儿接受腹腔镜联合阴囊小切口治疗的临床资料。观察治疗后睾丸下降入阴囊内的成功率、睾丸回缩、萎缩发生率及术后美观情况。结果:31例(39侧)低位隐睾患儿,除1例因精索太短将睾丸拉入腹腔内改为腹腔镜下睾丸松解下降固定术,其余均成功将睾丸降入阴囊内。术后随访患儿6月至4年,除1例睾丸回缩至外环口(经阴囊松解下降固定术后再无复发),余患儿通过彩超复查睾丸血供丰富、无睾丸萎缩及回缩、无腹股沟斜疝发生,手术切口处无明显疤痕或者疤痕小且较隐蔽,美观效果好。结论:腹腔镜联合阴囊小切口治疗低位隐睾既能达到满意的效果,且可及时诊治隐睾合并腹股沟斜疝及对侧腹股沟探查,术后手术切口疤痕不明显,手术时间短、对患儿的创伤较小,术后并发症少,美观效果好。

Objective:To investigate the efficacy of laparoscopic combined with scrotal small incision in the treatment of low cryptorchidism.Methods:The clinical data of 31 children(39 sides)with low cryptorchidism treated by laparoscopic combined with scrotal small incision in pediatric surgery of the Affiliated Hospital of Guangdong Medical University from March 2013 to March 2017 were analyzed retrospectively.The success rate of testicular descending into the scrotum,the incidence of testicular retraction and atrophy,and the postoperative aesthetics were observed after the operation.Results:In 31 cases(39 sides)of low cryptorchidism,the testis was lowered into the scrotum except for 1 case because the spermatic cord was too short and the testis was pulled into the abdominal cavity and replaced by laparoscopic release of testis.Postoperative follow-up was carried out for 6 months to 4 years.Except for 1 case of testicular retraction to the outer ring(via a scrotal neurolysis after orchiopexy without recurrence),the other children were examined through ultrasound review testicular blood supply and showed no testicular atrophy and retraction,no inguinal hernia,and no obvious surgical incision scar.There was good effect.Conclusion:Laparoscopy combined with scrotal small incision in the treatment of cryptorchidism can achieve satisfactory results.It can timely diagnose and treat cryptorchidism complicated with inguinal hernia and detect inguinal incision on the side with no obvious scar after surgery,less trauma,shorter operative time,less postoperative complications and good aesthetic effect.