Transumbilical two-port laparoscopic orchiopexy for high cryptorchidism
Yang Jun1, Zhong Xin1, Wang Jinyan2, Zou Xiaofeng1,Zhang Guoxi1, Yuan Yuanhu1, Xiao Rihai1, Wu Gengqing1,Wang Xiaoning1, Wu Yuting1, Long Dazhi1, Hu Dianshi2
1Department of Urology, First Affiliated Hospital of Gannan Medical University; Institute of Urology, Gannan Medical University, Ganzhou 341000, China; 2Department of Urology, People's Hospital of Huichang County
摘要目的:探讨经脐双通道腹腔镜手术治疗高位隐睾的安全性和有效性。方法:2013年1月~2014年12月,对12例(14侧)2~18岁,平均6.3岁的高位隐睾患者行经脐双通道腹腔镜隐睾下降固定术。左侧4例,右侧6例,双侧2例。于左右两侧脐缘各取0.5 cm切口穿刺置入5 mm Trocar,分别插入5 mm 30°腹腔镜或5.4 mm 0°远端可弯曲腹腔镜及操作器械,经阴囊切口置入无损伤分离钳,腹腔镜监视下经腹股沟管进入腹腔牵拉睾丸,将睾丸充分游离后牵入阴囊肉膜囊固定。结果:手术均获成功,其中11例(13侧)睾丸固定于阴囊底部,1例固定于阴囊顶部。平均手术时间46(35～90) min,估计术中出血量均少于5 ml;术后均未使用止痛药,术后3~5 d出院。术后平均随访8.6(2～24)个月,患侧睾丸无回缩、无萎缩;脐缘切口被周围的皱褶所遮蔽,瘢痕不明显。结论:经脐双通道腹腔镜隐睾下降固定术安全可行,创伤小,恢复快,美容效果好,疗效确切,值得临床选用。
Abstract：Objective: To evaluate the efficacy and safety of transumbilical two-port laparoscopic orchiopexy (TTLO) for high cryptorchidism. Methods: From Janurary 2013 to December 2014, 12 cases of high cryptorchidism underwent TTLO. The mean age was 6.3 (range 2 to 18) years. There were 4 cases on the left side, 6 cases on the right side and 2 cases on both sides. Two 5-mm trocars were inserted into abdominal cavity on the right and left umbilicus edges, respectively. A 5-mm 30° laparoscope or 5.4-mm 0° flexible laparoscope was inserted from one of the two 5-mm trocars. Under the detection of the laparoscope, a damage-free forceps was introduced into the abdominal cavity via the scrotal incision through the inguinal canal, which pulled down the testicle into the scrotum capsule for fixing. Results: All the operations were completed successfully. There were 11 cases (13 sides) whose testicles were fixed on the bottom of the scrotum, and 1 case on the top of scrotum. The mean operative time was 46 min for single side, and the mean postoperative hospital stay was 4 days. During a mean follow-up period of 8.6 (range 2 to 24) months, the two umbilicus scars were not obvious. No testicular retraction or atrophy was found. Conclusions: TTLO for high cryptorchidism was not only safe and effective but also had less complications and good cosmetic outcomes.
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