局解手术学杂志2024,Vol.33Issue(3) :260-264.DOI:10.11659/jjssx.03E023170

海氏三角入路腹腔镜Fowler-Stephens分期手术对小儿高位隐睾的疗效

Efficacy of two-staged laparoscopic Fowler-Stephens surgery through the Hay's triangle approach for the treat-ment of high cryptorchidism in children

丁岩 王建达 孙立宝
局解手术学杂志2024,Vol.33Issue(3) :260-264.DOI:10.11659/jjssx.03E023170

海氏三角入路腹腔镜Fowler-Stephens分期手术对小儿高位隐睾的疗效

Efficacy of two-staged laparoscopic Fowler-Stephens surgery through the Hay's triangle approach for the treat-ment of high cryptorchidism in children

丁岩 1王建达 1孙立宝1
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作者信息

  • 1. 秦皇岛市妇幼保健院小儿外科,河北 秦皇岛 066000
  • 折叠

摘要

目的 分析海氏三角入路腹腔镜Fowler-Stephens分期手术治疗小儿高位隐睾的效果.方法 回顾性分析我院116例高位隐睾患儿的临床资料,其中43例行海氏三角入路腹腔镜睾丸引降固定术的患儿作为对照组,73例行海氏三角入路腹腔镜Fowler-Stephens分期手术的患儿作为研究组.比较2组患儿手术前后性激素水平及睾丸功能变化.术后随访6个月,复查睾丸体积,记录并发症发生情况.结果 手术前后2组患儿睾丸体积比较差异无统计学意义(P>0.05),2组患儿术后并发症总发生率比较差异无统计学意义(P>0.05);术后2组患儿血清促卵泡生成素(FSH)、雌二醇(E2)、黄体生成素(LH)水平均较术前明显降低(P<0.05),血清睾酮(T)、抗苗勒管激素(AMH)、抑制素B(INHB)水平及INHB/FSH均较术前升高(P<0.05),但组间比较差异无统计学意义(P>0.05).结论 Fowler-Stephens分期手术治疗高位隐睾疗效较好,术中离断精索血管和睾丸引带可建立良好侧支循环,睾丸可下降至阴囊满意位置.

Abstract

Objective To analyze the efficacy of two-staged laparoscopic Fowler-Stephens surgery through the Hay's triangle approach for the treatment of high cryptorchidism in children.Methods The clinical data of 116 children with high cryptorchidism in our hospital were retrospectively analyzed,among which 43 children who underwent laparoscopic testicular extraction and fixation through the Hay's triangle approach were selected as the control group,and 73 children who underwent two-staged laparoscopic Fowler-Stephens surgery through the Hay's triangle approach were selected as the study group.The changes of sex hormone levels and testicular function before and after surgery were compared between the two groups.All patients were followed up for 6 months,and the testicular volume was reviewed and the occurrences of complications were recorded.Results There was no significant difference in the testicular volume before and after surgery between the two groups(P>0.05),and there was no significant difference in the total incidence of postoperative complications between the two groups(P>0.05).After surgery,the levels of serum follicle-stimulating hormone(FSH),estradiol(E2)and luteinizing hormone(LH)in the two groups were significantly lower than those before surgery(P<0.05),and the levels of serum testosterone(T),anti-Mullerian hormone(AMH),inhibin B(INHB)and INHB/FSH were significantly higher than those before surgery(P<0.05).However,there was no significant difference between the two groups(P>0.05).Conclusion The two-staged Fowler-Stephens surgery is effective in the treatment of high-risk cryptorchidism.It can establish a good collateral circulation by disconnection of spermatic cord vessels and gubernaculum testis,and the testis can be lowered to a satisfactory position in the scrotum.

关键词

高位隐睾/海氏三角/Fowler-Stephens分期手术/儿童/睾丸血运/腹腔镜/睾丸引降固定术

Key words

high cryptorchidism/Hay's triangle/two-staged Fowler-Stephens surgery/children/testicular blood supply/laparoscopic/testicular extraction and fixation

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出版年

2024
局解手术学杂志
重庆市解剖学会,第三军医大学

局解手术学杂志

CSTPCD
影响因子:1.063
ISSN:1672-5042
参考文献量21
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