35例腹腔型高位隐睾腹腔镜分期手术的疗效观察  

Clinical Observation of 35 Cases of Laparoscopic Staging of High Cryptorchidism with Abdominal Type

作　　者：钟陈[1] 胡小华[1] 张平锋[1] 张家德[1] ZHONG Chen;HU Xiaohua;ZHANG Pingfeng;ZHANG Jiade(Zhongshan Boai Hospital,Zhongshan 528402,China)

机构地区：[1]中山市博爱医院,广东中山528402

出　　处：《中国医药指南》2021年第21期52-53,56,共3页Guide of China Medicine

摘　　要：目的观察35例腹腔型高位隐睾腹腔镜分期手术(Fowler-stephens,F-S)的临床效果。方法随机选取我院2009年2月至2017年2月收治的35例小儿腹腔型高位隐睾患者为临床观察对象,所有患儿年龄5岁以下,针对所有患儿予以腹腔镜手术分期Fowler-Stephens(F-S),通过腹腔镜完成一期手术,6个月后经腹腔镜完成二次手术,记录患儿术前睾丸位置,经超声检测其睾丸大小,对比术前与术后的睾丸体积差异,探究其临床治疗效果。结果35例患儿的睾丸均无张力降入阴囊内,一期手术成功率为100.00%,平均手术时间(25.58±5.49)min,平均术中出血量为(1.48±0.25)mL;一期术后6个月行二期手术,平均手术时间(45.46±7.33)min,平均术中出血量为(2.16±0.37)mL;术后予以随访调查,术后1个月、术后3个月、术后6个月、1年、4年、4年以上时间的彩超检测显示,其均无血流信号异常,异常率为0。术前相应的患睾与健睾体积之比分别为0.64、0.56、0.65、0.48、0.47,显著低于术后对应时段患睾与健睾体积比(0.75、0.58、0.76、0.71、0.68),P<0.05。二期腹腔镜手术后,随访调查显示,患儿患睾术后的平均体积为(0.62±0.02)mL,显著高于术前的(0.30±0.05)mL,P<0.001,且35例患儿在术后1年内,未见睾丸回缩与其他并发症,并发症发生率为0。结论腹腔型高位隐睾患儿予以腹腔镜Fowler-Stephens分期手术疗效确切,安全性高,可有效改善预后,值得推广。Objective To observe the clinical effect of laparoscopic staging operation(F-S)for 35 cases of abdominal high cryptorchidism.Methods Thirtyfive cases of children with abdominal high cryptorchidism in our hospital from February 2009 to February 2017 were randomly selected as the clinical observation objects.All the children were under 5 years old.For all children,laparoscopic surgery was performed by stages Fowler-Stephens(F-S).The primary operation was completed by laparoscopy,and the second operation was completed by laparoscopy 6 months later,record the position of the testis of the child before the operation,and detect the size of the testis by ultrasound,compare the difference between preoperative and postoperative testicular volume,and explore its clinical therapeutic effect.Results The success rate of the first stage operation was 100.00%,the average operation time was(25.58±5.49)min,the average intraoperative blood loss was(1.48±0.25)mL;six months after the first stage operation,the second stage operation was performed,the average operation time was(45.46±7.33)min,and the average intraoperative blood loss was(2.16±0.37)mL.Follow-up investigations were performed after surgery,color Doppler ultrasound examinations at 1 month,3 months,6 months,1 year,4 years,and more than 4 years after surgery showed that there was no abnormal blood flow signal,and the abnormal rate was 0.The volume ratios of affected and healthy testes before operation were 0.64,0.56,0.65,0.48 and 0.47 respectively,which were significantly lower than those of 0.75,0.58,0.76,0.71 and 0.68 of the volume ratios of diseased and healthy testes in the corresponding period after operation.After the second stage laparoscopic surgery,the follow-up survey showed that the average volume of testis after operation was(0.62±0.02)mL,which was significantly higher than that before operation(0.30±0.05)mL,P<0.001.No testicular retraction and other complications were found in 35 patients within 1 year after operation,and the incidence of complications wa

关 键 词：腹腔型高位隐睾 腹腔镜手术 分期手术 睾丸 

分 类 号：R588.1[医药卫生—内分泌] R726.9[医药卫生—内科学]