摘要
目的评价经脐单部位多通道腹腔镜一期Fowler－Stephens（F－S）治疗腹腔内高位隐睾的临床疗效。方法回顾性分析2011年1月至2017年1月在首都儿科研究所附属儿童医院行经脐单部位多通道腹腔镜一期F－S的30例腹腔内隐睾患儿的临床资料，设为观察组。年龄1～8岁，平均18个月；单侧22例，双侧8例，共38只睾丸。同期行传统腹腔镜分期F－S手术的31例腹腔内隐睾患儿设为对照组，年龄11个月～9岁，平均20个月；单侧23例，双侧8例，共39只睾丸。术后定期随访，以睾丸术后下降的位置及有无萎缩为评价指标，观察2组手术疗效及术后并发症，评价2种手术方法的效果有无差异性。结果所有患儿顺利完成腹腔镜手术，无术中并发症。观察组中38只睾丸均行一期F－S手术，对照组39只睾丸均行分期F－S手术。术后并发症：观察组阴囊切口感染及阴囊血肿各1例，对照组腹壁气肿、肠梗阻、脐部感染各1例。术后随访6个月～6年，平均24个月，2组术后睾丸均位于阴囊内，无睾丸回缩，2组各有1只睾丸萎缩，其余睾丸术后彩超检查血运均正常。一期和分期F－S手术的术后并发症及术后疗效比较差异均无统计学意义（χ^2＝0.184、0.107，均P〉0.05）。结论经脐单部位多通道腹腔镜一期F－S手术治疗腹腔内隐睾与传统腹腔镜分期F－S术后效果无明显差别，可使一部分患儿避免再次手术和二次麻醉，该术式疗效满意，但需严格掌握其适应证和禁忌证。
ObjectiveTo evaluate the clinical effect of treatment for high intra-abdominal cryptorchidism of children with transumbilical single-site and multichannel laparoscopic single stage Fowler-Stephens （F-S） orchiopexy.MethodsThe case records of the intra-abdominal cryptorchidism of children who had undergone transumbilical single-site laparoscopic single stage F-S orchiopexy were reviewed retrospectively in Children′s Hospital Affiliated to Capital Institute of Pediatrics between January 2011 and January 2017, were assigned as the observation group, whose age ranged from 1 to 8 years and average age was 18 months, with 22 unilateral and 8 bilateral, 38 testis in total.A total of 31 children with intra-abdominal cryptorchidism who had undergone laparoscopic two stage F-S orchiopexy were assigned as the control group, whose age was from 11 months to 9 years and average age was 20 months, with 23 unila-teral and 8 bilateral, 39 testis in total.Postoperative follow-ups were conducted with the evaluation index included the testical position, with or without atrophy.The procedure effect and postoperative complications were observed, and the difference between two operation methods was evaluated.ResultsOperations in all cases were successful in both groups without intraoperative complication.A total of 38 testis were operated with single stage F-S orchiopexy in the observation group, and 39 testis were operated with two stage F-S orchiopexy in the control group.Postoperative complications included scrotum wound infection one case and scrotum hematoma in one case in the observation group, and abdominal wall emphysema in one case, intestinal obstruction in one case as well as umbilicus infection 1 case in control group.Follow-ups ranged from 6 months to 6 years, median 24 months.All testicals were within the scrotum, and each group had 1 case of testical atrophy.The difference of postoperative complication and effect between two groups had no statistical significance（χ^2=0.184, 0.107, all P〉0.05）.ConclusionsOutcomes between single stage and two stage F-S orchiopexy are similar.The transumbilical single-site laparoscopic F-S orchiopexy not only has the satisfactory effect, but also saves some patients from reoperation and secondary anaesthesia, but doctors must be aware of the indications and contraindications of this procedure should be brought to attention.
作者
郭立华
郝春生
牛志尚
张晨捷
王弘扬
Guo Lihua;Hao Chunsheng;Niu Zhishang;Zhang Chenjie;Wang Hongyang(Department of Pediatric Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Chin;Department of Urology,Children＇s Hospital Affiliated to Capital Institute of Pediatrics,Beijing 100020,China)
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2018年第21期1657-1661,共5页
Chinese Journal of Applied Clinical Pediatrics
