소아 고환종양에서 고환보존술의 적용 가능성
Feasibility of Testis-sparing Surgery for Testicular Tumors in Children
우광재, 한덕현, 박관현,
소속 상세정보
우광재 ( Woo Kwang-Jae )
성균관대학교 의과대학 비뇨기과학교실
한덕현 ( Han Deok-Hyun )
성균관대학교 의과대학 비뇨기과학교실
박관현 ( Park Kwan-Hyun )
성균관대학교 의과대학 비뇨기과학교실
KMID : 0358320070480060598
Abstract
Purpose: We assessed the feasibility of testis-sparing surgery in children with testicular tumors.
Materials and Methods: Twenty-five pediatric patients who had a testicular tumor were enrolled for retrospective analysis. Testis-sparing surgery was planned in the cases with clinical features that preoperatively suggested the tumors to be benign, which was later determined intraoperatively by frozen section examination. The preoperative-fetoprotein(AFP) and transscrotal ultrasound(US) were evaluated along with the final pathology. We reviewed the immediate and late surgical complications, as well as the tumor recurrence after surgery.
Results: Teratoma, epidermoid cyst, yolk sac tumor, and Leydig cell tumor accounted for finding in 40%, 32%, 24%, and 4% of the patients, respectively. Based on the preoperative US, 18 patients had benign-looking tumors. According to the age-matched AFP references, 17 patients showed normal ranges preoperatively. Out of 14 patients, whose US and AFP level suggested the tumors to be benign, 10(71.4%) were eligible for testis- sparing surgery on retrospective review. Testis-sparing surgery was performed in 5 patients, who showed the same pathology in frozen sections (3 epidermoid cysts, 2 teratomas). None of the 5 patients exhibited perioperative complications, and no recurrence or atrophy was observed at a mean follow-up of 39.8 months.
Conclusions: Out of 14 patients, whose US and AFP analyses were available, 10(71.4%) were eligible for testis-sparing surgery. Testis-sparing surgery was done in five out of the 10 patients without any complication or recurrence. Testis-sparing surgery is a feasible option in children with testicular tumors if the AFP level is within a normal range and the US suggests benign characteristics.(Korean J Urol 2007;48:598-602)
키워드
Testis;Tumor;Surgery;Children
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