腹腔镜下治疗非腹腔型隐睾的临床研究.docVIP

腹腔镜下治疗非腹腔型隐睾的临床研究 郑 键，林 涛，魏光辉，李旭良，何大维，刘俊宏，张德迎（重庆医科大学附属儿童医院泌尿外科，重庆 400014） 摘 要:目的探讨腹腔镜在非腹腔型隐睾治疗中的临床意义。方法将我院2007年3月到2007年9月间收治的非腹腔型隐睾病人47例，随机分为开放手术组23例和腹腔镜手术组24例，分别行开放手术睾丸下降固定术和腹腔镜下睾丸下降固定术，通过分析手术结果及各组术前及术后6个月的睾丸体积（V）、性激素水平（T、FSH、LH、E2）值的变化来判断腔镜手术的疗效。结果47例均成功行一期睾丸下降固定术，腹腔镜手术组，术前、术后自身比较，术后6月睾丸位置满意，睾丸体积无缩小（P0.05）、T 较术前升高（P0.05）、FSH及E2较术前下降（P0.05）、LH与术前无明显变化(P0.05)；腹腔镜手术组与开放手术组比较，两组术前及术后6月，V、T、FSH、E2、LH均无差别（P0.05）。结论腹腔镜在非腹腔型隐睾的治疗中安全、有效，与传统开放手术疗效相同，可做为非腹腔型隐睾手术治疗的常规术式。 ’s Hospital, Chongqing Medical University, Chongqing 400014, China) Abstract: Objecitve To explore the clinical significance of nonabdominal crptorchidism treatment under laparscope. Methods 47 patients of nonabdominal cryptorchidism administrated in our hospital from March, 2007 to September, 2007 were divided into open-surgery group (23 cases) and laparoscopic surgery group(24 cases) randomly, and orchidopexy was carried out respectively. Operation time, length of stay and testicular volum, hormone level (T, FSH, LH, E2) of each patient before operation and 6m after operation were measured to evaluate the efficacy. Results 47 patients were all carried out orchidopexy successfully. There was no significent difference of operation time between laperoscopic and open-surgery group, length of stay decrease in the former group. Testicular positation was satisfactory 6m after operation in laperoscopic group, and volum wasn’t decreased, while T level increased, FSH, E2 decreased than that before operation(P0.05), LH had no significant changes. Testicular volum, level of T, FSH, E2 and LH had no evident difference between laparoscopic and open-surgery group before and 6m after operation. Conclusion It’s safe and effective to treat nonabdominal cryptorchidism under laparoscope, which may adapted as routine treatment. Key words: crptorchidism; laparoscope 隐睾是小儿泌尿外科常见疾病之一，目前手术为主要治疗手段，对于腹腔型隐睾的治疗，腹腔镜为首选术式，已为大家所认可。对于非腹腔型隐睾的治疗，现多采用开放手术治疗，然而近来我们发现，腹腔镜在非腹腔型隐睾的手术治疗中，同样方便、、lintao272@ 收稿日期：2009-02-23；修回日期：2009-05-03 1 材料与