腹腔镜手术治疗小儿前列腺囊的临床疗效探讨  

Clinical analysis of laparoscopic treatment of prostate cyst in children

作　　者：吴永隆 徐延波 胡杨[1] 陈海琛 WU Yonglong;XU Yanbo;HU Yang;CHEN Haichen(Department of Pediatric Surgery,Women and Children,s Hospital,Xiamen University,Fujian,361003,China)

机构地区：[1]厦门大学附属妇女儿童医院小儿外科,福建厦门361003

出　　处：《临床泌尿外科杂志》2021年第12期985-988,共4页Journal of Clinical Urology

摘　　要：小儿前列腺囊发病率低,不过在重型尿道下裂术后发现前列腺囊的比例不在少数,因此,前列腺囊逐渐引起临床重视。前列腺囊手术方式包括开放手术和腹腔镜手术2种,开放手术常由于暴露欠佳手术完整切除困难,损伤大、复发率高、并发症多,已逐渐被淘汰目前多采用腹腔镜手术,因此探讨腹腔镜手术在小儿前列腺囊治疗的临床应用效果具有重要意义。本研究回顾性分析2013年8月—2018年10月在我院收治手术的5例前列腺囊患儿,发病年龄1.2~5.2岁,平均2.3岁。其中1例为2岁患儿反复尿路感染,经抗感染治疗无效;余4例患儿为尿道下裂术后反复附睾炎,经保守治疗无效,术前均行尿流率检查,除外尿道狭窄。5例患儿均在腹腔镜下完成前列腺囊切除,均切断双侧输精管。结果发现患儿在术后7~10 d拔除尿管,均无尿瘘发生;随访1~6年,5例患儿临床症状均消失,未再发生尿路感染或附睾炎,复查VCUG,均未见明显前列腺囊影。对于有症状的前列腺囊患儿,腹腔镜手术能取得良好治疗效果,手术的关键在于完整切除囊肿及与其相连的输精管并保持尿道完整通畅。The incidence of prostate cyst in children is low, but the proportion of prostate cyst found after severe hypospadias is not small. Therefore, the prostate cyst gradually attracts clinical attention. The treatment of prostate cyst includes open surgery and laparoscopic surgery. Open surgery is difficult to resect completely due to limited surgical exposure, and has gradually become obsolete because of its disadvantages of more damage, high recurrence rate and high incidence of complication. To explore the clinical application of laparoscopic surgery is of great significance. We retrospectively analysed 5 children with prostate cyst in our hospital from August 2013 to October 2018. Their age ranged from 1.2 years to 5.2 years with an average of 2.3 years. Among them, one two-year-old case was found repeated urinary tract infection, and the effect of anti-infection treatment is not good. The remaining four cases were found repeated epididymitis after hypospadias surgery, and conservative treatment was also ineffective. None of them was diagnosed as urethral stricture by preoperative urine flow rate examination. All of the 5 children underwent resection of prostate cyst and bilateral vasectomy. No urinary fistula occurred after removing the catheter 7-10 days postoperatively. During the follow-up period of 1-6 years, the clinical symptoms of 5 children disappeared, and no urinary tract infection or epididymitis occurred again. Laparoscopic surgery can achieve good therapeutic effect in children with symptomatic prostate cyst. The key of operation is to remove the prostate cyst and the connecting vas deferens and keep the urethra intact.

关 键 词：前列腺囊 儿童 腹腔镜 治疗 

分 类 号：R697[医药卫生—泌尿科学]