Use of Laparoscopy for Impalpable Testis

在12位1.5-11.5歲的隱睪症患者（共14個睪丸），我們成功地做了腹腔鏡檢查及處理。其中六個睪丸（43%），發現存在腹腔內－四個接受一般的睪丸固定術；而兩個睪丸因為嚴重萎縮及病人年紀較大，所以施行經腹腔鏡睪丸切除術。兩位病人（14%）在腹腔內可見到輸精管及精索血管的盲端皆別終止於內鼠蹊環的近端，因此診斷為〝腹腔睪丸消失症〞。在另外五位病人（6個睪丸），腹腔鏡下可見精索血管與輸精管會合於內鼠蹊環，經鼠蹊部探查術，五個分別有不等程度萎縮的睪丸做了睪丸固定術，而一個因切除之精索遠端小塊在病理上無睪丸組織存在，故診斷為〝鼠蹊消失睪丸症〞。在摸不到睪丸的隱睪症患者，腹腔鏡的處理是項很重要的工具，因為其不只侵襲性小，能提供正確的診斷及進一步手術的位置，而且對腹腔內消失睪丸症的病人，更能避免不必要的探查手術。

關鍵字

腹腔鏡；隱睪症；睪丸固定術；睪丸切除術

並列摘要

Laparoscopic intervention was successfully performed in twelve patients between 1.5 and 11.5 years of age, who had fourteen impalpable testes. Six of the 14 testes (43%) were found to be intraabdominally located. Simple orchiopexy was performed in four of them, and laparoscopic orchiectomy was do,ie smoothly in the other two due to severely hypo plastic changes of the testes and the ages of the patients. Two cases (14%) were found to have intra-abdominal vanishing testis with blind ends of vas deferens and obliterated spermatic vessels observed separately proximal to the internal inguinal ring. Vas deferens and spermatic vessels were noted to converge at the internal ring with patent processus vaginalis in five cases (six testes); inguinal exploration showed 5 testes of varying degrees of hypoplastic changes and one inguinal vanishing testis. Laparoscopic intervention is an important tool in the cryptorchid patients with impalpable testes because it can not only provide accurate diagnosis, well planning of the incisional site and minimal invasiveness, but also avoid unnecessary surgical exploration in the cases of intra-abdominal vanish testis.

並列關鍵字

laparoscopy ； cryptorchidism ； orchiopexy ； orchiectomy

國際替代計量

Use of Laparoscopy for Impalpable Testis

全文下載

主題瀏覽