촉지되지 않는 정류고환에서 복강경을 이용한 수술의 초기 경험
Therapeutic Laparoscopy for Impalpable Testis
소속 상세정보
이안기/Ahnkie Lee
윤종민/박문수/최황/Jong Min Yun/Moon Soo Park/Hwang Choi
KMID : 0358319970380080848
Abstract
결론
저자들은 94년 6월부터 97년 2월까지 10명의 촉지되지 않는 정류고환 환자 (12개의 고환)
의 수술에 복강경시술을 시도하였으며 고환고정술 시행한 환아의 90%에서 만족할 만한 결
과를 얻었다. 복강경 술기의 미숙으로 초기에 요관손상이 1례 발생하였으나, 술기의 습득단
계를 거친후에는 복강경하 고환고정술은 복강내 정류고환의 수술적 치료중 안전하고 효과적
인 방법으로 자리를 잡을 수 있을 것으로 생각된다.
#초록#
Management of impalpable testis is one of the most controversial issues in
cryptorchidism. There is wide variation in approach to this subset of patients. In the
child with an impalpable testis, laparoscopy is increasingly used as the diagnostic study
of choice. We have recently extended its value by using it as a therapeutic tool. Ten
laparoscopic surgical procedures were performed in 10 patients with 12 intra-abdominal
testes. In 2 adults with a small intra-abdominal testis and normal contralateral testis,
laparoscopic orchiectomy was performed. In 3 patients with 5 intra-abdominal testes, the
first phase of two-stage Fowler-Stephens orchiopexy was performed. These patients
underwent an open surgical procedure three or four months later. In 3 patients, one
stage orchiopexy was performed without dividing the spermatic vessels. In 2 Patients
these testes could be mobilized after division of the spermatic vessels (laparoscopic
one-stage Fowler-stephens orchiopexy). follow-up ranged from 3 months to 35 months
(mean 16.8 months). At follow up 9 of 10 testes (90%) are in the scrotum without
atrophy, while 1 (10%) is atrophic. Our early results suggest that increased experience
will allow laparoscopic surgery to be a valuable option in the treatment of impalpable
testis.
키워드
Laparoscopy; Cryptorchidism; Orchiopexy;
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