下腹横纹小切口治疗小儿隐睾

目的 探讨微创技术在小儿隐睾手术中的应用.方法 根据小儿隐睾的临床特点,设计一种新的微创手术方式,即经下腹横纹小切口治疗小儿隐睾,切口长1.5～2.5 cm,部分切开腹股沟管前壁,提出睾丸及精索,分离鞘突管至腹膜外脂肪后结扎鞘状突,将睾丸下降固定于阴囊肉膜囊内的方法治疗小儿隐睾120例.术后随访6个月至2年,并与同期经传统腹股沟大斜切口手术的35例进行对比.结果 120例出院时睾丸均位于阴囊内,术后获随访92例,其中31例术前高位隐睾患儿术后睾丸位于阴囊中部,其余睾丸位于阴囊底部,未发现睾丸萎缩;与同期行传统腹股沟大斜切口手术治疗35例小儿隐睾疗效相当.结论 采用下腹横纹小切口治疗小儿隐睾创伤小,手术快,术后切口瘢痕不明显,外形美观,疗效满意,可替代传统腹股沟大斜切口手术治疗小儿隐睾.

SURGICAL OPERATION OF CRYPTORCHIDISM IN CHILDREN BY TRANSVERSE INCISION OF LOWER INGUINA DERMATOGLYPH

Objective To explore the application of minimally invasive surgery to treat children's cryptorchidism.Methods According to clinical features of cryptorchidism,a new surgical procedure via a 1.5～2.5cm transverse incision of lower inguina dermatoglyph was performed by revealing anterior wall of inguinal canal and cutting a segment to search testicle and spermatic cord and to dissect vaginal process to inner ring part of inguinal canal and ligate it,and then make orchiopexy in dartos muscle of scrotum.A total of 120 children with the cryptorchidism underwent the newly designed procedure and were followed up 6～24 months.in order to compare the curative offect of new surgical procedure,35 cases of cryptorchidism wnderwent traditional surgical technigue were used as compared patients.Results All the patients were discharged with satisfactory testicular position in the scrotum.Follow-up 92 cases showed the testes located in scrotum.The 31 cases,testes of them which were cryptorchidism of inner ring part of inguinal canal before operation located in the middle-part scrotum and others located in the bottom-part scrotum,all with no testicular atrophy.There was no statistically significant between two surgical procedure to treat the curative effect of chileren's cryptorchidism.The surgical outcomes were not different with that of those patients who undenvent trditional surgical poeration.Conclusion The newly designed surgical procedure of minute transverse incision of lower inguina dermatoglyph is of micro-wound,shorter operation-time,minute scar of incision、beautiful outlook of skin after poeration,and satisfactory curative effect.It may replace traditionary surgical technique and well worthy to be intrlduced into clinical practice.