【摘要】 目的:比较腹腔镜辅助睾丸固定术和传统腹股沟阴囊切口睾丸固定术在治疗儿童合并鞘状突未闭的腹股沟型隐睾中的临床效果。方法:选取2021年6月～2023年12月安徽省儿童医院收治的70例合并鞘状突未闭的腹股沟型隐睾患儿，根据随机数字表法，将患儿分为腹腔镜辅助睾丸固定术为腔镜组(n=35例),传统腹股沟阴囊切口睾丸固定术为开放组(n=35例)。比较两组：(1)手术资料及术后并发症：手术时间、术中出血量、手术切口长度、术后住院时间及住院费用；伤口感染、腹股沟斜疝或鞘膜积液、睾丸回缩、睾丸萎缩。(2)睾丸发育情况：术前及术后6个月彩超睾丸大小。结果:70例手术均顺利完成，腔镜组无中转开放。与开放组相比，腔镜组手术时间短、出血量少、切口长度小、术后住院时间短、住院费用高，差异均有统计学意义(P<0.05);腔镜组和开放组出院时均未出现切口感染，开放组出院后出现3例切口感染；两组术后均未出现睾丸回缩、睾丸萎缩、腹股沟疝或鞘膜积液；术后6个月，两组睾丸大小均较手术前增加，差异均有统计学意义(P<0.001),增加幅度差异无统计学意义(P>0.05)。结论:腹腔镜辅助睾丸固定术在治疗合并鞘状突未闭的隐睾时，具有手术时间短、术中出血量少、术后恢复迅速、切口美观、术后并发症发生率低的优点，还可有效解决对侧鞘状突未闭。在治疗儿童合并鞘状突未闭的腹股沟型隐睾时值得推广。更多还原

【Abstract】 Objective:To compare the clinical efficacy of laparoscopy-assisted orchiopexy and traditional inguinal-scrotal incision orchiopexy in the treatment of inguinal cryptorchidism with patent processus vaginalis in children.Methods:Seventy children with inguinal cryptorchidism complicated with patent inguinal process admitted to Anhui Children′s Hospital were included between June 2021 and December 2023,and divided into laparoscopy-assisted testicular fixation group(n=35) and traditional inguinal scrotal incision testicular fixation group(n=35) by the random number table method.Then the two groups were compared regarding the surgical information(including surgical duration, intraoperative blood lose volume, incision length, postoperative hospital stay and hospitalization costs),and incidence of postoperative complications(including incision infection, indirect inguinal hernia, hydrocele, testicular retraction and testicular atrophy) as well as testicular development judged by the testicular size on color Doppler ultrasound before surgery and 6 months after surgery.Results:The surgery was successfully completed in the 70 children without any transferring to open surgery in the laparoscopy-assisted testicular fixation group.Compared with traditional inguinal scrotal incision testicular fixation group, the laparoscopy-assisted group had shorter surgical time, less intraoperative bleeding, smaller incision length, shorter days of postoperative hospital stay, yet higher hospitalization costs.The difference was significant(P<0.05).No incision infection occurred in both groups at discharge, yet the incision infection occurred in 3 cases in the open surgery group after discharge.There was no incidence of testicular retraction, testicular atrophy, inguinal hernia, or hydrocele after surgery.Six months after surgery, both groups showed an increase in testicular size compared to before surgery, with statistical significance(P<0.001),however, there was no significant difference in the amplitude of testicular size increase between the two groups of patients after surgery(P>0.05).Conclusion:Laparoscopy-assisted testicular fixation surgery in the treatment of cryptorchidism combined with syringomyelia has the advantages of short operative time, low intraoperative bleeding, rapid postoperative recovery, better incision appearance, and low incidence of postoperative complications, and it can also effectively resolve the contralateral syringomyelia.Therefore, this surgical modality is worthy of wider recommendation in the treatment of inguinal cryptorchidism with patent processus vaginalis in children.更多还原