Fowler-Stephens一期手术治疗高位隐睾的效果及对中远期性激素水平的影响

The effect of Fowler Stephens’One-stage Operation on High Cryptorchidism and Its Effect on Mid and Long-term Sex Hormone Levels

目的探讨腹腔镜Fowler-Stephens一期手术治疗高位隐睾的效果及对患者性激素水平的影响。方法选取2019年12月至2020年10月在我院接受腹腔镜手术治疗的64例高位隐睾患儿作为研究对象。根据手术方案将其中35例行Fowler-Stephens一期固定手术的患儿作为试验组,另29例行腹腔镜下睾丸固定术的患儿作为对照组,比较两组的患儿的治疗效果。结果两组未出现中转开放手术病例,均于术后第一天出院,治疗效果均达到临床预期。试验组出现1例阴囊血肿,对照组出现4例阴囊血肿,发生率比较差异有统计学意义(P<0.05),随访显示两组均未出现睾丸回缩和睾丸萎缩的情况;两组手术时间比较差异无统计学意义(P>0.05)。两组手术前、后的睾丸体积组内及组间比较差异无统计学意义(P>0.05)。两组患儿治疗前、后的睾酮、雌二醇、黄体生成素水平无明显变化,两组术前促卵泡激素差异无统计学意义(P>0.05),术后比较差异有统计学意义(P<0.05)。结论腹腔镜下Fowler-Stephens一期手术治疗高位隐睾整体效果良好,离断精索血管会对患儿的促卵泡激素造成影响,但幅度可控。

Objective To investigate the effect of laparoscopic Fowler Stephens one-stage operation on high cryptorchidism and its effect on the level of sexual hormones in patients.Methods 64 children with high cryptorchidism who underwent laparoscopic surgery in our hospital from December 2019 to October 2020 were selected as the research objects.According to the surgical plan,35 children who underwent Fowler Stephens primary fixation surgery were taken as the experimental group,and the other 29 children who underwent laparoscopic testicular fixation were taken as the control group.The therapeutic effects and safety of the two groups were compared.Results There was no conversion to open surgery in the two groups,and both were discharged on the first day after surgery,and the treatment effect reached clinical expectations.There was 1 case of scrotal hematoma in the experimental group and 4 cases of scrotal hematoma in the control group.The incidence difference was statistically significant(P<0.05);There was no significant difference in operation time between the two groups(P>0.05).There was no significant difference in testicular volume before and after operation between the two groups(P>0.05).There was no significant change in the levels of testosterone,estradiol and luteinizing hormone between the two groups before and after treatment.There was no statistically significant difference in follicle stimulating hormone between the two groups before operation(P>0.05),and there was statistically significant difference after operation(P<0.05).Conclusion The overall effect of laparoscopic Fowler Stephens one-stage operation for high cryptorchidism is good.The disconnection of spermatic cord vessels will affect the follicle stimulating hormone in children,but the amplitude is controllable.