一侧高位一侧低位隐睾的腹腔镜治疗体会  

Experience of Laparoscopic Treatment of One Side High and One Side Low Cryptorchidism

作　　者：宁峰 龙兴宇 姚逸凡 何军[1] Ning Feng;Long Xingyu;Yao Yifan(Department of Urology,Children’s Hospital Affiliated to Xiangya Medical College,Central South University,Hunan Children’s Hospital,Changsha 410007,China)

机构地区：[1]中南大学湘雅医学院附属儿童医院、湖南省儿童医院泌尿外科,长沙410007 [2]南华大学儿科学院,长沙410007

出　　处：《中国微创外科杂志》2024年第12期805-808,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：湖南省科技创新引导项目(2021SK50517)。

摘　　要：目的探讨一侧高位一侧低位隐睾的腹腔镜治疗效果。方法2020年1月~2022年12月,腹腔镜手术治疗双侧隐睾19例,一侧低位隐睾(腹股沟可扪及),另一侧高位隐睾(腹腔内)。年龄1岁1个月~11岁5个月,中位数2岁4个月。低位侧行睾丸引降固定术,同时高位侧行腹腔镜Fowler-Stephens(FS)分期手术的Ⅰ期手术,术后6个月行腹腔镜FS的Ⅱ期手术。结果19例均顺利完成手术。术后失访1例,18例随访3~23个月(末次彩超时间),中位数4个月。17例睾丸正常生长发育,1例合并努南综合征者术后15个月双侧睾丸萎缩(直径<1 cm),血运正常。结论一侧高位一侧低位隐睾可以在低位侧睾丸固定手术同期行高位侧睾丸腹腔镜FSⅠ期手术,6个月后再行高位侧腹腔镜FS的Ⅱ期手术。Objective To investigate the clinical effect of laparoscopic treatment of one side high and one side low cryptorchidism.Methods From January 2020 to December 2022,19 cases of bilateral cryptorchidism were treated by laparoscopic surgery,with low cryptorchidism on one side(palpable in the groin)and high cryptorchidism on the other side(in the abdominal cavity).The age range was 1 year and 1 month to 11 years and 5 months,with a median of 2 years and 4 months.The low cryptorchidism was operated with orchiopexy,and the high cryptorchidism was operated with laparoscopic two-staged Fowler-Stephens(FS)stageⅠsurgery and then laparoscopic FS stageⅡsurgery after 6 months.Results All the 19 cases were successfully operated.One case was lost to follow-up after surgery,and 18 cases were followed up for 3-23 months(last ultrasound time),with a median of 4 months.A total of 17 cases had normal testicular growth and development,and 1 case with combined Noonan syndrome had bilateral testicular atrophy(diameter<1 cm)and normal blood supply at 15 months after surgery.Conclusions One side high and one side low cryptorchidism can be treated simultaneously with the low side testicular fixation surgery and the high side laparoscopic FS stageⅠsurgery.Six months later,the high side laparoscopic FS stageⅡsurgery can be performed.

关 键 词：双侧隐睾 高位隐睾 腹腔镜手术 睾丸引降固定术 Fowler-Stephens分期手术 

分 类 号：R726.9[医药卫生—儿科]