摘要
本文报道2016年4月~2017年5月我科采用Shehata术对5例腹腔型高位隐睾在腹腔镜下分期行牵引睾丸固定术:一期腹腔镜下切断睾丸引带,在睾丸远端沿引带两侧扇形切开腹膜,游离精索血管和输精管(游离时尽量避免电钩对输精管和精索血管的损伤),同时将固定睾丸(缝合睾丸白膜)在对侧髂前上棘内上方2.5 cm处(即髂前上棘与脐膀胱皱襞间)。6~8周后再次腹腔镜探查,睾丸均无坏死。拆除缝线,腹股沟做小切口,将睾丸引出,检查精索无扭转,置入阴囊缝合固定在皮肤与肉膜间。5例睾丸均存活,安放固定位置合适。随访6个月,睾丸无回缩,无萎缩和皮肤内凹现象,彩超提示睾丸血供良好。我们认为Shehata术分期睾丸牵拉固定术保留睾丸主要血供,成活率高,利用肠管重力渐进牵引拉伸血管,安全可靠,效果良好。
A total of 5 cases of high intraabdominal cryptorchidism were treated with Shehata technique of two-stage laparoscopic traction orchiopexy from April 2016 to May 2017. For the first stage, the gubernaculum was cut off under direct vision of laparoscopy, the peritoneum was fan-shaped opened along the distal side of the testis, and then the vas deferens and spermatic cord were divided （avoiding the injury of the vas deferens and spermatic cord vessels with electric hook）. The testis was fixed on the anterior superior iliac spine at 2.5 cm above the albuginea （between the anterior superior iliac spine and umbilical bladder fold）. For the second stage, laparoscopic exploration was performed after 6-8 weeks. No necrosis was found in all testes and the suture was removed. A small incision in the groin was made and the testicle was extracted. The spermatic cord was checked if there was torsion or not, and the testicle was fixed in subdartos pouch. Finally, the testicles of the 5 patients survived and were fitted in a fixed position. No testicular retraction, atrophy, or skin recess was encountered during the follow-up of 6 months. The color Doppler ultrasound showed good blood supply. We deem that the Shehata technique of two-stage laparoscopic traction orchiopexy preserve the main blood supply of testosterone and improve testicular survival rate. The use of intestinal gravity for progressive traction to draw blood vessels is safe and reliable.
作者
段光琦
晋志远
刘洁
王啸
唐睿
随帮志
朱庆华
徐旭东
Duang Guangqi;Jin Zhiyuan;Liu Jie(Department of Pediatric Surgery,Yijishan Hospital of Wannan Medical College,Wuhu 241000,China)
出处
《中国微创外科杂志》
CSCD
北大核心
2018年第6期562-564,571,共4页
Chinese Journal of Minimally Invasive Surgery
关键词
隐睾
小儿
Shehata术
Intraperitoneal cryptorchidism
Children
Shehata technigue
