Application of laparoscopic Shehata technique for high intra-abdominal cryptorchidism
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摘要: 目的 探讨腹腔镜Shehata术治疗腹腔型高位隐睾的应用价值。方法 回顾性分析2017年6月—2019年3月我院采用腹腔镜Shehata术治疗15例(17侧)腹腔型高位隐睾患儿的临床资料。年龄9~36个月，平均14.5个月。左侧11例，右侧4例，双侧2例。一期在腹腔镜下离断睾丸引带，游离精索血管和输精管保留表面腹膜，将固定睾丸在对侧髂前上棘内上2.5 cm腹壁处。12周后行二期腹腔镜下睾丸下降固定术。结果 15例(17侧)手术均获成功，均下降并固定于阴囊内。一期手术平均手术时间(31.0±6.8) min，术中平均出血量(6.1±2.3) mL。二期手术平均手术时间(46.5±15.6) min，术中平均出血量(7.2±3.0) mL。术后3、6、12个月复查阴囊超声，未发生睾丸回缩、萎缩及皮肤内凹现象，全部患儿睾丸均血供良好。结论 腹腔镜Shehata术对腹腔内高位隐睾是一种可选的有效的手术方式，可有效保留睾丸主要血供，成活率较高，可临床推广应用。Abstract: Objective To evaluate the clinical significance of laparoscopic Shehata technique in the treatment of high intra-abdominal cryptorchidism.Methods A total of 15 (17 sides) children with high cryptorchidism treated by laparoscopic Shehata technique from June 2017 to March 2019 were included. The age ranged from 9 months to 36 months old (mean, 14.5 months old). There were 11 left-sided cases and 4 right-sided cases (included 2 bilateral cases). All patients were treated in this procedure: in the first stage, the testis was fixed on the anterior superior iliac spine at 2.5 cm above the albuginea. In the second stage, laparoscopic exploration was performed twelve weeks later.Results The testicles of the 15 patients (17 sides) were successfully fitted in a fixed position. The mean operative time of first stage was (31.0±6.8) min, and the mean estimated blood loss was (6.1±2.3) mL. The mean operative time of second stage was (46.5±15.6) min. The mean estimated blood loss was (7.2±3.0) mL. No complications happened during the operation. The ultrasound results showed that all the testicles have good blood supply in the 3rd, 6th and 12th month.Conclusion Laparoscopic Shehata technique could preserve the main blood supply of testicle and improve testicular survival rate. It is safe and feasible.
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Key words:
- laparoscopic /
- cryptorchidism /
- children /
- Shehata technique
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