层面外科理念下的一种全新的睾丸鞘膜翻转切除术15例经验
A new type of hydrocelectomy under trans-interfascial plane surgical technique:15 cases of experience
王思成 1贾斌 1樊体武1
作者信息
- 1. 长治医学院附属和平医院泌尿外科,山西长治 046000
- 折叠
摘要
目的 在层面外科的理念下描述一种全新的睾丸鞘膜翻转切除术,改进对睾丸鞘膜积液手术解剖层次的理解并优化手术方式.方法 选取2021年1-6月长治医学院附属和平医院泌尿外科收治的15例原发性睾丸鞘膜积液患者,采用经精索内筋膜层面行保留引带血管的睾丸鞘膜囊翻转切除术进行治疗.收集分析患者的一般资料、手术相关指标、成功率和并发症,并通过术中所见及照片分析术中的解剖学结构及结构间相互关系.结果 15例患者均成功完成手术,手术时间为25～48 min,平均(34.0±6.2)min,患者均未出现阴囊血肿或切口感染,术后3个月随访无复发.术中所见解剖学要点如下:精索内筋膜完整包绕睾丸、附睾及精索,该层面是无血管的手术入路;在原发性睾丸鞘膜积液患者中,提睾肌及其筋膜层面是缺如的,与精索外筋膜相邻的是精索内筋膜;术中保留引带有助于睾丸固定于自然位置.结论 在精索内筋膜层面行保留引带血管的睾丸鞘膜翻转切除术疗效可靠,层面外科理念下的精准解剖描述有助于提升相关手术技术.
Abstract
Objective A new type of testicular hydrocele reversal resection is described under the concept of trans-interfascial plane surgery,in order to improves the understanding of the anatomical level of testicular hydrocele surgery and to optimize the surgical approach.Methods During Jan.and June 2021,15 patients with primary testicular hydrocele were treated with hydrocelectomy and gubernaculum preservation.Demographic information,indications of treatment,success rate and complications were collected.The anatomical structures were analyzed using intraoperative findings and photographs.Results All operations of 15 patients were successful,with the surgery time of 25-48 minutes,with an average of(34.0±6.2)minutes.No patients experienced scrotal hematoma or incision infection.There were no relapses during the 3-month follow-up after surgery.The anatomical points observed during surgery were as follows:we further confirmed that the internal spermatic fascia completely surrounded the testis,epididymis,and the spermatic cord;this layer was an avascular plane,the cremaster muscle and fascial layer between the internal and external spermatic fasciae were absent;intraoperative preservation of the gubernaculum helped to fix the testicles in its natural position.Conclusion Our novel technique of hydrocelectomy is reliable,and the precise anatomical description of the concept of trans-interfascial plane surgery can help to improve the related surgical techniques.
关键词
睾丸鞘膜积液/睾丸鞘膜翻转切除术/睾丸/精索内筋膜/层面外科Key words
testicular hydrocele/hydrocelectomy/testis/internal spermatic fascia/trans-interfascial plane surgery引用本文复制引用
基金项目
长治医学院附属和平医院院级科研基金(2019)(HPYJ201930)
出版年
2024
NETL
NSTL
万方数据