[1]杨周健 杨健 唐青松 宋鹏 刘钧**.腹腔镜下Prentiss路径睾丸下降固定术的新认识[J].中国微创外科杂志,2022,01(6):463-466.
　Yang Zhoujian,Yang Jian,Tang Qingsong,et al.New Understanding on Laparoscopic Prentiss Tunnel Orchiopexy for Children With High Cryptorchidism[J].Chinese Journal of Minimally Invasive Surgery,2022,01(6):463-466.
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腹腔镜下Prentiss路径睾丸下降固定术的新认识()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2022年6期
页码:
463-466
栏目:
临床研究
出版日期:
2022-10-11

文章信息/Info

Title:
New Understanding on Laparoscopic Prentiss Tunnel Orchiopexy for Children With High Cryptorchidism
作者:
杨周健 杨健 唐青松 宋鹏 刘钧**
(绵阳市中心医院小儿外科，绵阳621000)
Author(s):
Yang Zhoujian;  Yang Jian;  Tang Qingsong;  et al.
Department of Pediatric Surgery, Mianyang Central Hospital, Mianyang 621000, China
关键词:
腹腔镜; 隐睾; 小儿; Prentiss路径
Keywords:
Laparoscopy; Cryptorchidism; Children; Prentiss tunne
文献标志码:
A
摘要:
目的总结腹腔镜下Prentiss路径睾丸下降固定术的经验。方法2017年8月～2021年7月我院行腹腔镜下Prentiss路径睾丸下降固定术66例。全身麻醉联合骶管麻醉。脐部切口建立气腹，置入5 mm观察镜，平脐偏下平面稍外侧建立操作通道，检查患侧睾丸血管及输精管发育情况，整体游离精索、输精管及睾丸，经海氏三角钝性建立下降通道，将睾丸牵引下降至阴囊并固定。结果手术时间33~74 min，(40.2±7.1)min。术中出血1~4 ml，(2.0±0.8)ml。腹腔内睾丸5侧，窥视睾丸30侧，腹股沟管内隐睾38侧。合并同侧腹股沟斜疝30例，鞘膜积液2例，行腹腔镜下内环口缝合15例，腹膜外疝囊高位结扎或鞘状突高位结扎术22例。术后患儿麻醉清醒后逐渐恢复饮食，2例患儿切口感染，换药处理后愈合。66例随访4~50个月，中位随访时间20个月，患儿阴囊外观满意，未见复发、睾丸萎缩等表现。结论Prentiss路径延长下降距离，睾丸血供最大程度得以保留，术中注意对睾丸及睾丸血管的保护，正确判断睾丸下降距离。
Abstract:
ObjectiveTo summarize the experience of laparoscopic Prentiss tunnel orchiopexy in children with high cryptorchidism.MethodsWe reviewed 66 cases of laparoscopic Prentiss tunnel orchiopexy in our hospital from August 2017 to July 2021. All the cases were given caudal anesthesia combined with general anesthesia. Artificial pneumoperitoneum was established through an umbilical incision. A 5 mm laparoscope was placed in the abdominal cavity, and two operation channels were established slightly below the umbilical plane. The development of the affectedside spermatic vessels and vas deferens were observed. The funiculus spermaticus, deferent ducts and testis were separated as a whole carefully. The access of testicular descent was established bluntly through the Hessel bach Triangle, then the testis was pulled out and fixed to the scrotum.ResultsThe operative time was 33-74 min (mean, 40.2±7.1 min) and the intraoperative hemorrhage was 1-4 ml (mean, 2.0±0.8 ml). There were 5 sides of testis in the abdominal cavity, 30 sides of peeping testis, and 38 sides of cryptorchidism in the inguinal canal. There were 30 cases of combined ipsilateral indirect inguinal hernia and 2 cases of ipsilateral hydrocele. A total of 15 patients accepted laparoscopic pursestring suture of the hernia, and 22 patients accepted laparoscopic percutaneous extraperitoneal closure or laparoscopic high ligation of processus vaginalis. The children recovered to normal diet gradually after anesthesia recovery. Wound infection was found in 2 cases and healed up by dressing. During followups for 4-50 months (median, 20 months) in the 66 cases, the appearance of scrotum was satisfactory, and no recurrence, testicular atrophy or other manifestations were found.ConclusionsThe Prentiss tunnel extends the descent distance, and testicular blood supply is preserved to the greatest extent. During the operation, the protection of testis and testicular blood vessels should be paid attention to, and the descent distance of testis should be correctly judged.

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备注/Memo

备注/Memo:
基金项目：电子科技大学绵阳市中心医院课题（2021YJ005）**通讯作者，Email:yniver@yeah.net
更新日期/Last Update: 2022-10-11