腹腔镜完全腹膜外疝修补术对睾丸血流及血清睾酮的影响

【摘要】〓目的〓初步探讨腹腔镜完全腹膜外无张力腹股沟疝修补术(TEP)对睾丸血流及血清睾酮的影响。方法〓对我科住院行手术治疗的男性单侧腹股沟疝患者进行前瞻性研究,应用高频彩超对行腹腔镜下腹股沟疝修补的男性患者在术前48 h内,术后48 h内、2周内、1个月内用彩色超声分别测定患者患侧和对侧精索动脉血流量,包括收缩期峰值血流速度(PSV)和舒张末期血流速度(EDV)和睾丸体积,以及检测血清睾酮水平。结果〓共66例最终被选择入组。术前48 h内,患侧和对侧的PSV、EDV和睾丸体积差异均无明显异常(P>0.05);术后48 h及术后两周均检测到患侧的PSV、EDV和睾丸体积明显小于对侧,差异具有统计学意义(P<0.05)。而术后1个月内,患侧和对侧的PSV、EDV和睾丸体积差异均无统计学意义(P>0.05)。术前48 h内,术后48 h内、2周内及1个月的患者血浆睾酮水平的差异无统计学意义(P>0.05)。结论〓TEP术治疗腹股沟疝时,术后早期(2周内)可降低患侧的睾丸血流和睾丸体积,但术后1个月可恢复正常;TEP术对腹股沟疝患者的血清睾酮无明显影响。不需进行干预。

The influence of total extraperitoneal herniorrhaphy on testicular blood flow and serum testosterone

Objective To investigate the totally extraperitoneal laparoscopic tension-free inguinal hernia repair (TEP) and its influence on testicular hemodynamics. Methods Sixty-six cases with unilateral inguinal hernia were enrolled in a prospective internally controlled cohort study, and were performed totally laparoscopic extraperitoneal tension-free inguinal hernia repair (TEP). Pre- and post-operative blood flow parameters of bilateral testicular arteries, including peak systolic velocity (PSV), end diastolic velocity (EDV), testicular volume and plasma testosterone level were studied and compared. Results In pre-operation of 48 hours, there were no statistical differences in PSV, EDV and testicular volume between the both side (all P values >0.05). In post-operation of 48 hours and two weeks after operation,PSV、EDV and testicular volume of the affected side were significantly lower than that of the other side (all P values <0.05). PSV, EDV and testicular volume were not significantly different in one month after operation. There were no statistically significant differences in plasma testosterone level in pre-operation of 48 hours, post-operation of 48 hours, 2 weeks after operation and one month after operation. Conclusion Testicular hypotension occurred in two weeks after TEP procedure on the affected side, and improved in 1 month later. Plasma testosterone level were not influenced.