小儿腹腔镜隐睾手术中保留睾丸引带与切断引带术后睾丸发育情况的对比分析

Comparative Analysis of Testicular Development after Retaining Testicular Lead and Cutting Testicular Lead in Laparoscopic Cryptorchidism in Children

摘要: 目的：探究小儿腹腔镜隐睾手术中保留睾丸引带对睾丸发育情况的影响。方法：2016年1月~2021年12月收治于青岛大学附属医院小儿外科、行保留睾丸引带的腹腔镜睾丸固定术的98例患儿(3周岁以内)作为观察组，选择同期行传统开放式手术治疗的同类患儿127例作为对照组。收集手术相关指标，随访1年，记录两组患儿睾丸体积变化、并发症及复发情况。结果：两组患儿手术相关情况，其手术时间、住院时间及术中出血量，其差异无统计学意义(P > 0.05)。两组发生术后阴囊血肿并发症的概率差异无统计学意义(P > 0.05)，而保留引带组发生术后睾丸回缩、睾丸萎缩并发症的概率小于断引带组，其差异有统计学意义(P < 0.05))。对照组与观察组两组对比，术前患侧与健侧睾丸体积差异无统计学意义(P > 0.05)，而两组术后1年患侧睾丸体积，观察组高于对照组，差异有统计学意义(P < 0.05)，术后1年两组健侧睾丸体积差异无统计学意义(P > 0.05)。两组术后1年患侧睾丸增长体积，观察组睾丸体积大于对照组，差异有统计学意义(P < 0.05)，术后1年健侧睾丸增长体积差异无统计学意义(P > 0.05)。结论：腹腔镜保留睾丸引带的隐睾下降固定术较离断睾丸引带的传统手术方式治疗隐睾，通过尽可能多地保留睾丸血运，降低了隐睾术后睾丸萎缩并发症发生率，促进了隐睾患儿术后患侧睾丸发育。

Abstract: Objective: To explore the effect of retaining testicular lead on testicular development during laparoscopic cryptorchidism in children. Methods: From January, 2016 to December, 2021, 98 children (less than 3 years old) who were admitted to the Pediatric Surgery Department of the Affiliated Hospital of Qingdao University and underwent laparoscopic orchiectomy with testicular band preservation were used as the observation group, and 127 children of the same kind who underwent traditional open surgery at the same time were selected as the control group. The indexes related to operation were collected and followed up for one year, and the changes of testicular volume, complications and recurrence of the two groups were recorded. Results: There was no significant difference between the two groups in operation-related conditions, operation time, hospitalization time and intraoperative blood loss (P > 0.05). There was no statistically significant difference in the probability of postoperative scrotal hematoma complications between the two groups (P > 0.05), but the probability of postoperative testicular retraction and testicular atrophy complications in the group with retained belt was lower than that in the group with broken belt (P < 0.05). There was no significant difference in testicular volume between the control group and the observation group before operation (P > 0.05), but the testicular volume of the affected side in the observation group was higher than that in the control group one year after operation (P < 0.05), and there was no significant difference in testicular volume of the healthy side in the two groups one year after operation (P > 0.05). One year after operation, the testicular volume of the affected side of the two groups increased, and the testicular volume of the observation group was larger than that of the control group, the difference was statistically significant (P < 0.05), but there was no statistical difference in the testicular volume of the healthy side one year after operation (P > 0.05). Conclusion: Compared with the traditional surgical method of removing the testicular lead, laparoscopic cryptorchidism with testicular lead preservation can reduce the incidence of testicular atrophy’s complications after cryptorchidism and promote the development of the affected testis in children with cryptorchidism.