Efficacy of two-staged laparoscopic Fowler-Stephens surgery through the Hay's triangle approach for the treatment of high cryptorchidism in children

DING Yan; WANG Jian-da; SUN Li-bao

doi:10.11659/jjssx.03E023170

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Efficacy of two-staged laparoscopic Fowler-Stephens surgery through the Hay's triangle approach for the treatment of high cryptorchidism in children

Clinical Research | 更新时间：2024-04-01

- Efficacy of two-staged laparoscopic Fowler-Stephens surgery through the Hay's triangle approach for the treatment of high cryptorchidism in children
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 33, Issue 3, Pages: 260-263(2024)
- 作者机构：
  
  秦皇岛市妇幼保健院小儿外科，河北秦皇岛 066000
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.03E023170
  CLC： R726.9
- Published：25 March 2024，
  
  Received：27 March 2023，
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丁岩,王建达,孙立宝.海氏三角入路腹腔镜Fowler-Stephens分期手术对小儿高位隐睾的疗效[J].局解手术学杂志,2024,33(03):260-263.

DING Yan,WANG Jian-da,SUN Li-bao.Efficacy of two-staged laparoscopic Fowler-Stephens surgery through the Hay's triangle approach for the treatment of high cryptorchidism in children[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(03):260-263.
丁岩,王建达,孙立宝.海氏三角入路腹腔镜Fowler-Stephens分期手术对小儿高位隐睾的疗效[J].局解手术学杂志,2024,33(03):260-263. DOI： 10.11659/jjssx.03E023170.

DING Yan,WANG Jian-da,SUN Li-bao.Efficacy of two-staged laparoscopic Fowler-Stephens surgery through the Hay's triangle approach for the treatment of high cryptorchidism in children[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(03):260-263. DOI： 10.11659/jjssx.03E023170.

摘要

目的

分析海氏三角入路腹腔镜Fowler-Stephens分期手术治疗小儿高位隐睾的效果。

方法

回顾性分析我院116例高位隐睾患儿的临床资料，其中43例行海氏三角入路腹腔镜睾丸引降固定术的患儿作为对照组，73例行海氏三角入路腹腔镜Fowler-Stephens分期手术的患儿作为研究组。比较2组患儿手术前后性激素水平及睾丸功能变化。术后随访6个月，复查睾丸体积，记录并发症发生情况。

结果

手术前后2组患儿睾丸体积比较差异无统计学意义（

0.05），2组患儿术后并发症总发生率比较差异无统计学意义（

0.05）；术后2组患儿血清促卵泡生成素（FSH）、雌二醇（E2）、黄体生成素（LH）水平均较术前明显降低（

0.05），血清睾酮（T）、抗苗勒管激素（AMH）、抑制素B（INHB）水平及INHB/FSH均较术前升高（

0.05），但组间比较差异无统计学意义（

0.05）。

结论

Fowler-Stephens分期手术治疗高位隐睾疗效较好，术中离断精索血管和睾丸引带可建立良好侧支循环，睾丸可下降至阴囊满意位置。

Abstract

Objective

To analyze the efficacy of two-staged laparoscopic Fowler-Stephens surgery through the Hay's triangle approach for the treatment of high cryptorchidism in children.

Methods

The clinical data of 116 children with high cryptorchidism in our hospital were retrospectively analyzed，among which 43 children who underwent laparoscopic testicular extraction and fixation through the Hay's triangle approach were selected as the control group，and 73 children who underwent two-staged laparoscopic Fowler-Stephens surgery through the Hay's triangle approach were selected as the study group.The changes of sex hormone levels and testicular function before and after surgery were compared between the two groups.All patients were followed up for 6 months，and the testicular volume was reviewed and the occurrences of complications were recorded.

Results

There was no significant difference in the testicular volume before and after surgery between the two groups （

0.05），and there was no significant difference in the total incidence of postoperative complications between the two groups （

0.05）.After surgery，the levels of serum follicle-stimulating hormone （FSH），estradiol （E2） and luteinizing hormone （LH） in the two groups were significantly lower than those before surgery （

0.05），and the levels of serum testosterone （T），anti-Mullerian hormone （AMH），inhibin B （INHB） and INHB/FSH were significantly higher than those before surgery （

0.05）.However，there was no significant difference between the two groups （

0.05）.

Conclusion

The two-staged Fowler-Stephens surgery is effective in the treatment of high-risk cryptorchidism. It can establish a good collateral circulation by disconnection of spermatic cord vessels and gubernaculum testis，and the testis can be lowered to a satisfactory position in the scrotum.

关键词

高位隐睾海氏三角Fowler-Stephens分期手术儿童睾丸血运腹腔镜睾丸引降固定术

Keywords

high cryptorchidismHay's triangletwo-staged Fowler-Stephens surgerychildrentesticular blood supplylaparoscopictesticular extraction and fixation

references

Wang CY，Wang Y，Chen XH，et al.Efficacy of single-stage and two-stage Fowler-Stephens laparoscopic orchidopexy in the treatment of intraabdominal high testis［J］.Asian J Surg，2017，40（6）：490-494.doi：10.1016/j.asjsur.2016.11.008http://dx.doi.org/10.1016/j.asjsur.2016.11.008.

徐青雨，孙中文，马志，等.单孔腹腔镜联合Bianchi手术治疗儿童高位隐睾的临床研究［J］.中国现代医生，2023，61（1）：27-30.doi：10.3969/j.issn.1673-9701.2023.01.007http://dx.doi.org/10.3969/j.issn.1673-9701.2023.01.007.

刘锋，蔡林浩.腹腔镜在睾丸下降固定术中的应用效果［J］.医疗装备，2022，35（19）：79-81.doi：10.3969/j.issn.1002-2376. 2022.19.026http://dx.doi.org/10.3969/j.issn.1002-2376.2022.19.026.

曹海波，刘振勇，李一帆.腹腔镜下经改良Prentiss路径睾丸下降固定术治疗小儿高位隐睾临床研究［J］.临床泌尿外科杂志，2021，36（12）：937-941.doi：10.13201/j.issn.1001-1420.2021.12.004http://dx.doi.org/10.13201/j.issn.1001-1420.2021.12.004.

杨周健，杨健，唐青松，等.腹腔镜下Prentiss路径睾丸下降固定术的新认识［J］.中国微创外科杂志，2022，22（6）：463-466.doi：10.3969/j.issn.1009-6604.2022.06.004http://dx.doi.org/10.3969/j.issn.1009-6604.2022.06.004.

Neheman A，Shumaker A，Grazi J，et al.Standardized single-stage laparoscopic Fowler-Stephens orchiopexy regardless of testis position：modification of technique eliminates the need for intra-operative decision-making［J］.J Minim Access Surg，2022，18（4）：591-595.doi：10.4103/jmas.jmas_312_21http://dx.doi.org/10.4103/jmas.jmas_312_21.

宋晋秋，白东升，郝春生，等.经腹腔镜Fowler-StephensⅠ期手术及分期手术治疗儿童高位隐睾的临床对比研究［J］.北京医学，2020，42（12）：1193-1196.doi：10.15932/j.0253-9713.2020.12.006http://dx.doi.org/10.15932/j.0253-9713.2020.12.006.

王银彪.腹腔镜微创手术治疗小儿隐睾的临床价值［J］.实用中西医结合临床，2022，22（21）：44-47.doi：10.13638/j.issn.1671-4040.2022.21.012http://dx.doi.org/10.13638/j.issn.1671-4040.2022.21.012.

高鹏，高莉娟.腹腔镜结合阴囊小切口术治疗小儿隐睾症的手术效果及安全性分析［J］.航空航天医学杂志，2022，33（10）：1191-1194.doi：10.3969/j.issn.2095-1434.2022.10.015http://dx.doi.org/10.3969/j.issn.2095-1434.2022.10.015.

Park K， Choi H. An evolution of orchiopexy：historical aspect［J］.Korean J Urol，2010，51（3）：155-160.doi：10.4111/kju.2010. 51.3.155http://dx.doi.org/10.4111/kju.2010.51.3.155.

Alam A，Delto JC，Blachman-Braun R，et al.Staged Fowler-Stephens and single-stage laparoscopic orchiopexy for intra-abdominal testes：is there a difference？ A single institution experience［J］.Urology，2017，101（1）：1-7.doi：10.1016/j.urology.2016.09.060http://dx.doi.org/10.1016/j.urology.2016.09.060.

齐灿，周云，褚登伟，等.腹腔镜下分期Fowler-Stephens手术治疗小儿腹腔内高位隐睾的体会［J］.中国微创外科杂志，2021，21（5）：450-453.doi：10.3969/j.issn.1009-6604.2021.05.015http://dx.doi.org/10.3969/j.issn.1009-6604.2021.05.015.

黄文倩，黄桂珍，刘明学.微创筋膜闭合器辅助腹腔镜睾丸下降固定术治疗隐睾患儿的效果［J］.中外医学研究，2022，20（25）：130-133.doi：10.14033j.cnki.cfmr/2022.25.032http://dx.doi.org/10.14033j.cnki.cfmr/2022.25.032.

李骥，张谦，郭立华，等.经海氏三角下降途径的腹腔镜Fowler-Stephens分期睾丸固定术治疗儿童腹腔型隐睾［J］.郑州大学学报（医学版），2021，56（1）：128-131.doi：10.13705/j.issn.1671-6825.2020.01.160http://dx.doi.org/10.13705/j.issn.1671-6825.2020.01.160.

欧阳雨茹，郝春生.儿童隐睾术后睾丸萎缩相关因素的研究现状与诊治进展［J］.中华泌尿外科杂志，2022，43（5）：397-400.doi：10.3760/cma.j.cn112330-20210918-00497http://dx.doi.org/10.3760/cma.j.cn112330-20210918-00497.

Favorito LA，Costa SF，Julio-Junior HR，et al.The importance of the gubernaculum in testicular migration during the human fetal period［J］.Int Braz J Urol，2014，40（6）：722-729.doi：10.1590/S1677-5538http://dx.doi.org/10.1590/S1677-5538.

Rodprasert W，Koskenniemi JJ，Virtanen HE，et al.Reproductive markers of testicular function and size during puberty in boys with and without a history of cryptorchidism［J］.J Clin Endocrinol Metab，2022，107（12）：3353-3361.doi：10.1210/clinem/dgac520http://dx.doi.org/10.1210/clinem/dgac520.

陈楠，郝春生，杨丽红，等.经脐腹腔镜手术与传统手术治疗小儿高位隐睾的临床效果比较［J］.中国性科学，2022，31（4）：24-28.doi：10.3969/j.issn.1672-1993.2022.04.006http://dx.doi.org/10.3969/j.issn.1672-1993.2022.04.006.

Thorup J，Clasen-Linde E，Thorup SC，et al.Pre- and postoperative status of gonadotropins （FSH and LH） and inhibin-B in relation to testicular histopathology at orchiopexy in infant boys with unilateral undescended testes［J］.J Pediatr Urol，2015，11（1）：1-5.doi：10.1016/j.jpurol.2014.08.007http://dx.doi.org/10.1016/j.jpurol.2014.08.007.

Kato T，Mizuno K，Matsumoto D，et al.Low serum inhibin B/follicle-stimulating hormones and anti-Müllerian hormone/follicle-stimulating hormones ratios as markers of decreased germ cells in infants with bilateral cryptorchidism［J］.J Urol，2022，207（3）：701-709.doi：10.1097/JU.0000000000002344http://dx.doi.org/10.1097/JU.0000000000002344.

Hildorf SE，Clasen-Linde E，Cortes D，et al.The positive predictive value of using FSH and inhibin-B serum levels to diagnose gonadotropin insufficiency in bilateral cryptorchid boys is high［J］.J Pediatr Urol，2022，18（6）：844-850.doi：10.1016/j.jpurol.2022.10.031http://dx.doi.org/10.1016/j.jpurol.2022.10.031.

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