保留睾丸的肿瘤剜除术治疗儿童良性睾丸肿瘤

目的评价保留睾丸的肿瘤剜除术治疗儿童良性睾丸肿瘤的临床疗效。方法回顾性分析1998年10月到2009年3月收治的29例保留睾丸的肿瘤剜除术患儿临床资料。患儿平均发病年龄为42．6个月（4个月至12岁），临床表现均为无痛性阴囊肿块，除1例术前AFP升高外，其余术前AFP均在正常范围。结果均行保留睾丸的肿瘤剜除术，术后病理诊断：21例为成熟性畸胎瘤，2例为表皮囊肿，4例为皮样囊肿，1例为囊肿性病变伴肉芽肿形成，1例为未成熟畸胎瘤（后行睾丸切除术）。25例冰冻切片均诊断为良性病变。21例B超下计算肿瘤体积为（1．25±2．05）mL，患侧睾丸体积（含肿瘤）为（4．56±5．07）mL，肿瘤占睾丸体积比例为（54．3±30．11）％（6．04％～100％）。7例最近1次门诊随访术侧平均睾丸体积为（0．78±0．31）mL，与健侧比较无统计学意义。20例平均获随访34个月（4～72个月），无一例复发，患侧睾丸发育良好。结论保留睾丸的肿瘤剜除术可作为小儿睾丸良性肿瘤的首选治疗方法。

Experience with testicular sparing surgery for benign testicular tumor in 29 cases

Objective To evaluate the therapeutic effect of organ sparing surgery for benign testicular tumor in children. Methods 29 patients who underwent testicular sparing surgery between October 1998 to March 2009 were reviewed. Results The mean age at treatment was 42.6 months （4months to 12 years）. Painless scrotal mass was the common presentation by 14 cases on left side to 16 cases on right side. Preoperative AFP was normal in all the cases except one. The pathological diagnosis included 21 mature teratoma, 2 epidermoid cyst, 4 dermoid cyst, 1 cyst with granuloma, and 1 immature teratoma in which case orchieetomy was performed later. Frozen section analysis was requested in 25 cases with the result of all benign. 21 cases＇ preoperative ultrasonic data showed the volume of the tumors, the volume of the involved testes （ including the tumor）, and the ratio of the formers were 1.25±2.05ml, 4.56 ±5.07ml and 54.3 ±30.11% （6.04% ±100% ）, respectively. 7 cases＇ postoperative ultrasonic data showed the volume of the involved testes were 0.78 ±0.31ml, and there was no significance compared to the opposite ones. 20 patients received telephone interview by the average follow-up time of 34 months （4 months to 72 months） after operation, and there was no evidence of recurrence or testis atrophy in all of them. Conclusions Testicular sparing surgery should be the preferred treatment for children with benign tesficular tumor.