[1]杨周健 刘钧** 黄一东① 唐青松 杨健 陈曹婧 蒲永斌.腹腔镜Prentiss路径睾丸下降固定术28例[J].中国微创外科杂志,2019,01(10):925-928.
　Yang Zhoujian*,Liu Jun*,Huang Yidong,et al.Laparoscopic Prentiss Orchiopexy for 28 Children With High Cryptorchidism[J].Chinese Journal of Minimally Invasive Surgery,2019,01(10):925-928.
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腹腔镜Prentiss路径睾丸下降固定术28例()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2019年10期
页码:
925-928
栏目:
临床研究
出版日期:
2019-10-25

文章信息/Info

Title:
Laparoscopic Prentiss Orchiopexy for 28 Children With High Cryptorchidism
作者:
杨周健 刘钧** 黄一东① 唐青松 杨健 陈曹婧 蒲永斌
(四川省绵阳市中心医院小儿外科，绵阳621000）
Author(s):
Yang Zhoujian*;  Liu Jun*;  Huang Yidong;  et al.
*Department of Pediatric Surgery, Mianyang Central Hospital, Mianyang 621000, China
关键词:
腹腔镜; 隐睾; 儿童; 外科手术
Keywords:
Laparoscopy; Cryptorchidism; Children; Surgery
文献标志码:
A
摘要:
目的探讨腹腔镜Prentiss路径睾丸下降固定术在高位隐睾手术中的应用价值。方法回顾性分析2017年8月~2019年3月我院腹腔镜Prentiss路径睾丸下降固定术治疗28例儿童高位隐睾的临床资料。年龄8个月~7岁3个月，中位数1岁10个月。左侧8例，右侧17例，双侧3例。伴同侧腹股沟斜疝13例，鞘膜积液3例。在腹腔镜监视下，经腹腔镜操作剪刀、电凝钩等器械游离睾丸后离断引带，保留精索及输精管表面腹膜，松解精索及输精管，腹腔镜监视下经腹壁下血管内侧建立睾丸下降的Prentiss路径，经体外牵拉睾丸残留引带下降睾丸，体外牵引下再次于腹腔内游离精索，使睾丸能无张力下降至阴囊。结果手术时间35~64（45.1±6.9）min，出血<5 ml。术后均未使用止痛药，阴囊轻微肿胀，未放置引流条，无须使用抗生素。术后4 h饮水，6 h进流质饮食，1~2 d出院。28例术后随访1~20（8.5±5.5）月，无切口感染，睾丸均停留在阴囊内，阴囊外观良好，左右基本对称，无睾丸萎缩、鞘膜积液、腹股沟斜疝等并发症。结论腹腔镜Prentiss路径睾丸下降固定术治疗高位隐睾简单易学且安全有效，容易达到睾丸下降固定的目的。
Abstract:
ObjectiveTo evaluate the clinical significance of laparoscopic Prentiss orchiopexy in the treatment of high cryptorchidism.MethodsA total of 28 children with high cryptorchidism treated by laparoscopic Prentiss orchiopexy from August 2017 to March 2019 were retrospectively analyzed. The age ranged from 8 months to 7 years and 3 months old (median, 1 year and 10 months old). There were 8 left-sided cases, 17 right-sided cases, and 3 bilateral cases. There were 13 cases of ipsilateral indirect inguinal hernia and 3 cases of ipsilateral hydrocele. Under laparoscopic surveillance, hand instruments like laparoscopic scissors and electric coagulation hook were used to mobilize testicle and then to detach the gubernaculum ligament. The spermatic cord and vas deferens peritoneum were preserved, and then were released. Under the supervision of laparoscope, the Prentiss pathway of testicular descent was established through the medial side of the inferior epigastric vessels. Under in vitro traction, the testis was descended by pulling the residual gubernaculum remnant. If the tension was too high, the spermatic cord was mobilized again in the abdominal cavity under in vitro traction, so that the testis could be reduced to scrotum without tension.ResultsThe mean operative time was 35-64 (45.1±6.9) min and the bleeding was less than 5 ml. Postoperative pain symptoms were mild. No analgesics were used. The scrotum was slightly swollen, and no drainage strips were placed. No antibiotics were required. Drinking sips of water was started at 4 hours after operation, and liquid diet was started at 6 hours. The patients were discharged 1-2 days after operation. All the 28 cases were followed up for 1-20 months ［(8.5±5.5) months］. There was no incision infection. Testicles remained in the scrotum. The appearance of scrotum was good and the left and right sides were basically symmetrical. There were no complications such as testicular atrophy, hydrocele, or indirect inguinal hernia.ConclusionsPrentiss laparoscopic treatment is a simple, safe and effective method for the treatment of high cryptorchidism. It avoids staging operation and Fowler-Stephens operation to a certain extent, and is easy to achieve the purpose of descending testis fixation.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目：四川省科技厅项目（2017FZ0057）**通讯作者，E-mail:yniver@yeah.net①（四川大学华西医院小儿外科，成都610041）
更新日期/Last Update: 2020-01-09