中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2013年
26期
104-105,106
,共3页
腹腔镜%非触及%隐睾%睾丸一次性固定术%疗效
腹腔鏡%非觸及%隱睪%睪汍一次性固定術%療效
복강경%비촉급%은고%고환일차성고정술%료효
Laparoscopy%Non-touching%Cryptorchidism%Disposable testicular fixation%Efficacy
目的：观察腹腔镜治疗不可触及隐睾型隐睾的诊治效果。方法：选择本院2008年3月-2012年6月收治的186例不可触及隐睾患儿为研究对象，腹腔镜下探查186个睾丸，术前采用盆腔和阴囊腹股沟超声检查，随访2~36个月，确诊睾丸的位置、睾丸的大小、回缩、萎缩情况。结果：经过腹股沟和腹腔镜探查以及术后病理证实，睾丸缺如、残余分别为118、7个；腹股沟型高位隐睾12个；腹腔睾丸49个，21个为低位型，28个为高位型；真两性畸形2例，卵黄退化不全5例，条索状性腺2例。治疗方法为常规腹股沟手术（13个）；腹腔镜下一次性睾丸固定术（9个）；F-S分期睾丸固定术（24个）F-S一期睾丸固定术7个；睾丸切除术治疗大于不良睾丸3个；卵黄退化不全5例始基子宫切除；条索状性腺2例行性腺切除术；真两性畸形2例活检一侧为卵巢，一侧为睾丸；术后随访中患侧睾丸萎缩3个、回缩2个。结论：腹腔镜能对非触及型隐睾进行精准的诊断并同时进行科学合理有效的治疗，对于位于腹腔低位隐睾，采用腹腔镜下一次性固定术治疗效果明显优于常规手术，高位隐睾宜采用F-S分期手术进行治疗。
目的：觀察腹腔鏡治療不可觸及隱睪型隱睪的診治效果。方法：選擇本院2008年3月-2012年6月收治的186例不可觸及隱睪患兒為研究對象，腹腔鏡下探查186箇睪汍，術前採用盆腔和陰囊腹股溝超聲檢查，隨訪2~36箇月，確診睪汍的位置、睪汍的大小、迴縮、萎縮情況。結果：經過腹股溝和腹腔鏡探查以及術後病理證實，睪汍缺如、殘餘分彆為118、7箇；腹股溝型高位隱睪12箇；腹腔睪汍49箇，21箇為低位型，28箇為高位型；真兩性畸形2例，卵黃退化不全5例，條索狀性腺2例。治療方法為常規腹股溝手術（13箇）；腹腔鏡下一次性睪汍固定術（9箇）；F-S分期睪汍固定術（24箇）F-S一期睪汍固定術7箇；睪汍切除術治療大于不良睪汍3箇；卵黃退化不全5例始基子宮切除；條索狀性腺2例行性腺切除術；真兩性畸形2例活檢一側為卵巢，一側為睪汍；術後隨訪中患側睪汍萎縮3箇、迴縮2箇。結論：腹腔鏡能對非觸及型隱睪進行精準的診斷併同時進行科學閤理有效的治療，對于位于腹腔低位隱睪，採用腹腔鏡下一次性固定術治療效果明顯優于常規手術，高位隱睪宜採用F-S分期手術進行治療。
목적：관찰복강경치료불가촉급은고형은고적진치효과。방법：선택본원2008년3월-2012년6월수치적186례불가촉급은고환인위연구대상，복강경하탐사186개고환，술전채용분강화음낭복고구초성검사，수방2~36개월，학진고환적위치、고환적대소、회축、위축정황。결과：경과복고구화복강경탐사이급술후병리증실，고환결여、잔여분별위118、7개；복고구형고위은고12개；복강고환49개，21개위저위형，28개위고위형；진량성기형2례，란황퇴화불전5례，조색상성선2례。치료방법위상규복고구수술（13개）；복강경하일차성고환고정술（9개）；F-S분기고환고정술（24개）F-S일기고환고정술7개；고환절제술치료대우불량고환3개；란황퇴화불전5례시기자궁절제；조색상성선2례행성선절제술；진량성기형2례활검일측위란소，일측위고환；술후수방중환측고환위축3개、회축2개。결론：복강경능대비촉급형은고진행정준적진단병동시진행과학합리유효적치료，대우위우복강저위은고，채용복강경하일차성고정술치료효과명현우우상규수술，고위은고의채용F-S분기수술진행치료。
Objective:To observe the laparoscopic treatment of not palpable of cryptorchidism type cryptorchidism diagnosis and treatment effects. Method:186 cases of not palpable cryptorchidism children in our hospital from March 2008 to June 2012 were for the study.The laparoscopic probe 192 testicular,the preoperative pelvic and scrotal inguinal ultrasound follow-up of 2 to 36 months,confirmed location of the testis,testicular size, retraction,atrophy of the case.Result:After groin and laparoscopy and postoperative pathology confirmed,the testicular absence and remnants had 118 and 7 respectively;groin high cryptorchidism had 12;abdominal testis had 49,21 were lows,28 were high;True hermaphroditism had 2 cases, incomplete yolk degradation had 5 cases,cord-like gonadal had 2 cases.The conventional groin surgery(13);laparoscopic disposable Orchiopexy (9);The FS stage testicular fixation(24);the FS a Orchiopexy 7;orchiectomy treatment is greater than the adverse testicular 3;yolk incomplete degradation of 5 cases of primordial hysterectomy;cord-like gonads routine gonadectomy;the true hermaphroditism 2 biopsies side of ovarian,side of the testis;postoperative follow-up ipsilateral testicular atrophy,retraction had 2.Conclusion:Laparoscopic touched cryptorchidism accurate diagnosis and simultaneously scientific and rational and effective treatment,located in the abdominal lows cryptorchidism,the disposable laparoscopic fixation treatment is better than conventional surgery,high cryptorchidism should adopt the FS staging surgery for treatment.
