儿童隐睾症二次手术的临床疗效评价  

Clinical efficacy of secondary operation for cryptorchidism: a clinical analysis of 53 boys

作　　者：黄一天 温晟[1] 杨猛 刘星[1] 刘丰[1] 张德迎[1] 吴盛德[1] 石艳 倪园松 何佩儒 章志成 华燚[1] HUANG Yitian;WEN Sheng;YANG Meng;LIU Xing;LIU Feng;ZHANG Deying;WU Shengde;SHI Yan;NI Yuansong;HE Peiru;ZHANG Zhicheng;HUA Yi(Department of Urology,Key Laboratory of ChildrenUrogenital Development and Tissue Engineering,Children's Hospital of Chongqing Medical University,Chongqing,400014,China)

机构地区：[1]重庆医科大学附属儿童医院泌尿外科,儿童泌尿生殖发育与组织工程重点实验室,重庆400014

出　　处：《第三军医大学学报》2021年第3期267-270,共4页Journal of Third Military Medical University

摘　　要：目的探讨儿童隐睾症二次手术的必要性及其临床疗效。方法回顾性分析2012年1月至2020年4月本科接诊的53例首次隐睾术后睾丸未降至正常位置或术后复发的患儿病例资料,根据有无进行二次手术分为再手术组39例及观察组(未行二次手术,仅门诊随访)14例,随访时间(42.38±27.57)个月,最长随访8年。总结两组患儿随访过程中睾丸位置、有无并发症、恶变等指标。根据患儿年龄分为幼儿及青少年两个亚组,对比随访期睾丸的发育情况。结果再手术组患儿术后睾丸均降至阴囊内,术中发现30例鞘状突未闭,2例睾丸发生囊皮样改变。随访过程中1例出现睾丸血供减少,2例睾丸未再发育。观察组患儿中有2例睾丸位置发生变化,3例睾丸未再发育,1例出现血供减少。再手术组患儿睾丸发育情况优于观察组(P<0.05),所有患儿随访期间均无睾丸恶变。结论隐睾二次手术成功率高且术后睾丸发育情况优于仅观察随访的患儿,临床应积极实施。Objective To explore the necessity and evaluate the curative effect of redo orchiopexy for cryptorchidism after failure of primary orchiopexy.Methods Clinical data of 53 children with undescended testis(46 cases of unilateral cryptorchidism and 7 cases of bilateral)after the first orchiopexy in our department from January 2012 to April 2020 were collected and analyzed retrospectively.According to undergoing secondary surgical treatment or not,the boys were divided into reoperation group(n=39)and observation group(n=14,only receiving follow-up in clinic).They were followed up for averagely 42.38±27.57 months,with 8 years for the longest.The testicular position,complications and malignant changes during the follow-up were summarized in the 2 groups.The development of the testis was evaluated and compared between the child and adolescent subgroups.Results In the reoperation group,all the testes decreased to the scrotum after operation.During the operation,30 cases had patent sheath process and 2 cases had cystic skin-like changes in the testis.In the follow-up,decreased testicular blood supply was found in 1 case and no testicular development in 2 cases.In the observation group,the position of testis changed in 2 cases,and the testis no longer developed in 3 cases,and decreased blood supply in 1 case.The testicular development was better in the reoperation group than the observation group(P<0.05).There was no testicular malignant change during the follow-up period.Conclusion For the children with cryptorchidism whose testicular position did not decrease to normal after the primary operation,reoperation will obtain a higher success rate,and achieve better testicular development.Redo orchiopexy should be recommended.

关 键 词：隐睾 睾丸下降固定术 术后复发 

分 类 号：R619[医药卫生—外科学] R726.972.2[医药卫生—儿科]