CAJ | 학술논문

目的探讨腹腔镜下睾丸固定术治疗腹股沟型隐睾的可行性及微创优势. 方法腹股沟型隐睾患儿90例.年龄8个月～6岁,平均17个月.左侧24例、右侧53例、双侧13例,共103个睾丸.腹腔镜下离断鞘状突或疝囊,松解腹膜后精索,将睾丸拉入腹腔,离断引带;将睾丸拉入阴囊固定. 结果 90例103个睾丸手术均顺利,无中转开放手术者.平均手术时间(32.7±5.2)min.103个睾丸患侧鞘状突未闭93侧(90.3%);77例单侧隐睾对侧鞘状突未闭12例(15.6%).术中发生皮下气肿3例(3.3%),拔出套管后,经切口排出气体,气肿消失.术后随访6～12个月,103个睾丸均在阴囊内,无萎缩及睾丸回缩. 结论腹腔镜下腹股沟型隐睾固定手术安全、有效,弥补了开放术式破坏腹股沟管解剖完整性、腹膜后高位松解困难等缺陷.
목적 탐토복강경하고환고정술치료복고구형은고적가행성급미창우세. 방법 복고구형은고환인90례.년령8개월～6세,평균17개월.좌측24례、우측53례、쌍측13례,공103개고환.복강경하리단초상돌혹산낭,송해복막후정색,장고환랍입복강,리단인대;장고환랍입음낭고정. 결과 90례103개고환수술균순리,무중전개방수술자.평균수술시간(32.7±5.2)min.103개고환환측초상돌미폐93측(90.3%);77례단측은고대측초상돌미폐12례(15.6%).술중발생피하기종3례(3.3%),발출투관후,경절구배출기체,기종소실.술후수방6～12개월,103개고환균재음낭내,무위축급고환회축. 결론 복강경하복고구형은고고정수술안전、유효,미보료개방술식파배복고구관해부완정성、복막후고위송해곤난등결함.
Objective To investigate the feasibility and efficacy of laparoscopic orchiopexy for inguinal palpable undescended testes. Methods Ninety patients with 103 inguinal undescended pal-pable testes were treated by laparoscopic orchiopexy performed by the same surgeon. There were 24 (26.7 %) left and 53 (58. 9%) right palpable cryptorchidism cases, plus 13 cases (14.4 % ) with bilat-eral undescended testes. The mean age of the patients was 17 months (range 8 months-6 years). The surgical procedures were described as following. First, the peritoneum was opened at the anterior sur-face of the spermatic vessels and vas deferens before the testis was pulled into the abdominal cavity so that the spermatic vessels and vas deferens were released and easily manipulated. Second, the inter-space between internal spermatic fascia (transversalic fascia) and processus vaginalis was divided so, that the testis could be pulled into the abdominal cavity. Finally, the trocar which was inserted from scrotum was placed through the outer ring. Finally, the testis was placed at position and fixed. Re-suits The mean operative time was 32.7±5.2 min. The processus vaginalis unclose was found in 93 (90.3%) cases; and contralateral process us vaginalis unclose were found in 12 (15.6%) cases of 77 unilateral undescended testes. The complication rate was 3(3.3%)cases, all in bilateral cases. All 103 testes were descended by laparoscopy. On follow-up ranging 6-12 months, all testes maintained good size and a proper position. Conclusions The laparoscopic approach may be a safe way to descend the inguinal palpable testes. Orchiopexy of palpable undescended testes can be done with advantages in the laparoscopic approach.