| 摘要: |
| ［摘要］ 目的 探讨经直疝三角途径的腹腔镜Fowler-Stephens分期睾丸固定术治疗高位隐睾的效果。方法 招募2020年2月至2024年2月于临沂市中心医院小儿外科接受治疗的高位隐睾患儿200例，采用随机数字表法将其分为对照组（接受经直疝三角途径的腹腔镜睾丸引降固定术）和观察组（接受经直疝三角途径的腹腔镜Fowler-Stephens分期睾丸固定术），各100例。在治疗过程中，对照组脱落11例，最终纳入89例；观察组脱落2例，最终纳入98例。通过倾向性评分匹配（PSM）进行1∶1匹配，最终有75对患儿成功匹配。比较两组手术前及手术后6个月睾丸体积、性激素水平、睾丸功能的变化，比较两组治疗效果及并发症发生情况。结果 与术前相比，两组术后睾丸体积无显著变化（P>0.05），且两组间睾丸体积及临床疗效比较差异无统计学意义（P>0.05）。与术前比较，两组术后促卵泡生成素（FSH）、雌二醇（E2）水平下降，睾酮（T）、抗米勒管激素（AMH）、抑制素B（INHB）水平升高，差异有统计学意义（P<0.05），但两组间比较差异无统计学意义（P>0.05）。观察组和对照组并发症总发生率分别为8.00%和12.00%，差异无统计学意义（P>0.05）。结论 经直疝三角途径的腹腔镜Fowler-Stephens分期睾丸固定术治疗高位隐睾安全、有效。 |
| 关键词: 直疝三角 腹腔镜 Fowler-Stephens分期手术 高位隐睾 倾向性评分匹配 |
| DOI：10.3969/j.issn.1674-3806.2025.05.12 |
| 分类号: |
| 基金项目:山东省医药卫生科技发展计划项目（编号：202202080942） |
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| Exploring efficacy of staged laparoscopic Fowler-Stephens orchidopexy via direct inguinal triangle approach for high undescended testis based on propensity score matching |
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CAO Qingwei1,2, WANG Qian3, YANG Binyi1, LU Hongting1
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1.Pediatric Surgery Center, Women and Children′s Hospital, Qingdao University, Qingdao 266000, China; 2.Department of Pediatric Surgery, Linyi Central Hospital, Linyi 276400, China; 3.Intensive Care Unit of the First Department of Pulmonary Diseases, Qingdao Haici Hospital Affiliated to Qingdao University, Qingdao 266000, China
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| Abstract: |
| ［Abstract］ Objective To explore the efficacy of staged laparoscopic Fowler-Stephens orchidopexy via direct inguinal triangle approach for high undescended testis. Methods Two hundred pediatric patients with high undescended testes who were treated in the Department of Pediatric Surgery of Linyi Central Hospital from February 2020 to February 2024 were recruited. The pediatric patients were divided into control group(receiving laparoscopic testicular descent and fixation via direct inguinal triangle approach) and observation group(receiving staged laparoscopic Fowler-Stephens orchidopexy via direct inguinal triangle approach) by random number table method, with 100 cases in each group. During the treatment process, 11 cases dropped out in the control group, and 89 cases were eventually included. During the treatment process, 2 cases dropped out in the observation group, and 98 cases were eventually included. Ultimately, 75 pairs of the pediatric patients were successfully matched after conducting match at a ratio of 1∶1 through propensity score matching(PSM). The changes in testicular volume, sex hormone levels and testicular function were compared between the two groups before surgery and 6 months after surgery. The therapeutic effects and the occurrence of complications were compared between the two groups. Results Compared with that before operation, there was no significant change in testicular volume between the two groups after operation(P>0.05), and there were no statistically significant differences in testicular volume and clinical efficacy between the two groups after operation(P>0.05). Compared with those before operation, the levels of follicle-stimulating hormone(FSH) and estradiol(E2) decreased and the levels of testosterone(T), anti-Müllerian hormone(AMH), and inhibin B(INHB) increased in both groups after operation, with statistically significant differences(P<0.05), but there were no statistically significant differences between the two groups after operation(P>0.05). The total occurrence rates of complications in the observation group and the control group were 8.00% and 12.00%, respectively, with no statistically significant difference between the two groups(P>0.05). Conclusion The staged laparoscopic Fowler-Stephens orchidopexy via direct inguinal triangle approach is safe and effective in treatment of high undescended testis. |
| Key words: Direct inguinal triangle Laparoscope Staged Fowler-Stephens High undescended testis Propensity score matching(PSM) |
